Clinical Report on Lower Limb Deep Venous Thrombosis Complicated with Pulmonary Embolism in 45 Cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIANG Peng , LIU Jianlong , JIA Wei , TIAN Xuan

Department of Vascular Surgery， Beijing Jishuitan Hospital， Beijing 100035， China;

Corresponding author：

Keywords：

Deep venous thrombosis; Pulmonary embolism

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Objective 　To summarize the clinical manifestation and the causes of lower limb deep venous thrombosis （DVT） complicated with pulmonary embolism （PE）.
Method 　The clinical data of 45 cases of PE confirmed by CTPA from May 2009 to May 2012 in this hospital were summarized retrospectively.
Results 　Five patients with PE had no obvious clinical manifestation， 9 patients （20.0%） had chest stuffiness and short of breath， 8 patients （17.8%） had cough. In the causes of thrombosis defluxion：11 patients （24.4%） had early mobilization after operation， 9 patients （20.0%） had functional exercise after operation， 7 patients （15.6%） had turn over or defecate on bed， 2 patients （4.4%） had sneeze， 14 patients （31.1%） had no definite causes.
Conclusions 　Patients with lower limb DVT have high risk of thrombosis defluxion， although adequate anticoagulation. Early mobilization， functional exercise， and transient increased abdominal pressure are easy to lead to thrombosis defluxion， so lead to PE. Absence of the protection of inferior vena cava filter， patient should be required for bed ridden in order to avoid the thrombosis defluxion.

Citation： JIANG Peng,LIU Jianlong,JIA Wei,TIAN Xuan,.. Clinical Report on Lower Limb Deep Venous Thrombosis Complicated with Pulmonary Embolism in 45 Cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(11): 1179-1181. doi: Copy

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13.	刘建龙，贾伟. 骨折后深静脉血栓的早期诊断与处理[J]. 中华全科医师杂志， 2008， 7(6)：375-377.
14.	Giannoudis PV， Pountos I， Pape HC， et al. Safety and efficacy of vena cava filters in trauma patients[J]. Injury， 2007， 38(1)：7-18.
15.	Wojcik R， Cipolle MD， Fearen I， et al. Long-term follow-up of trauma patients with a vena caval filter[J]. J Trauma， 2000， 49(5)：839-843.
16.	Guyatt GH， Akl EA， Crowther M， et al. American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary：Antithrombotic therapy and prevention of thrombosis， 9th ed：American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J]. Chest， 2012， 141(2 Suppl)：7S-47S.

1. Heit JA， Melton LJ 3rd， Lohse CM， et al. Incidence of venous thromboembolism in hospitalized patients vs community residents[J]. Mayo Clin Proc， 2001， 76(11)：1102-1110.
2. Qaseem A， Snow V， Barry P， et al. Current diagnosis of venous thromboembolism in primary care：a clinical practice guideline from the American Academy of Family Physicians and the AmericanCollege of Physicians[J]. Ann Fam Med， 2007， 5(1)：57-62.
3. Knudson MM， Ikossi DG， Khaw L， et al. Thromboembolism after trauma：an analysis of 1 602 episodes from the American College of Surgeons National Trauma Data Bank[J]. Ann Surg， 2004， 240(3)：490-496.
4. Bell WR， Simon TL. Current status of pulmonary thromboembolic disease：pathophysiology， diagnosis， prevention， and treatment[J]. Am Heart J， 1982， 103(2)：239-262.
5. Lee LH， Gu KQ， Heng D. Deep vein thrombosis is not rare in Asia——the Singapore General Hospital experience[J]. Ann Acad Med Singapore， 2002， 31(6)：761-764.
6. Cheuk BL， Cheung GC， Cheng SW. Epidemiology of venous thromboembolism in a Chinese population[J]. Br J Surg， 2004， 91(4)：424-428.
7. Stein PD， Beemath A， Olson RE. Trends in the incidence of pulmonary embolism and deep venous thrombosis in hospitalized patients[J]. Am J Cardiol， 2005， 95(12)：1525-1526.
8. Sevitt S， Gallagher N. Venous thrombosis and pulmonaryembolism. A clinico-pathological study in injured and burnedpatients[J]. Br J Surg， 1961， 48：475-489.
9. Fowkes FJ， Price JF， Fowkes FG. Incidence of diagnosed deep vein thrombosis in the general population：systematic review[J]. Eur J Vasc Endovasc Surg， 2003， 25(1)：1-5.
10. Geerts WH， Heit JA， Clagett GP， et al. Prevention of venous thromboembolism[J]. Chest， 2001， 119(1 Suppl)：132S-175S.
11. Hansson PO， Welin L， Tibblin G， et al. Deep vein thrombosis and pulmonary embolism in the general population. ‘The Study of Men Born in 1913’[J]. Arch Intern Med， 1997， 157(15)：1665-1670.
12. Velmahos GC， Kern J， Chan L， et al. Prevention of venous thromboembolism after injury[J]. Evid Rep Technol Assess (Summ)， 2000， (22)：1-3.
13. 刘建龙，贾伟. 骨折后深静脉血栓的早期诊断与处理[J]. 中华全科医师杂志， 2008， 7(6)：375-377.
14. Giannoudis PV， Pountos I， Pape HC， et al. Safety and efficacy of vena cava filters in trauma patients[J]. Injury， 2007， 38(1)：7-18.
15. Wojcik R， Cipolle MD， Fearen I， et al. Long-term follow-up of trauma patients with a vena caval filter[J]. J Trauma， 2000， 49(5)：839-843.
16. Guyatt GH， Akl EA， Crowther M， et al. American College of Chest Physicians Antithrombotic Therapy and Prevention of Thrombosis Panel. Executive summary：Antithrombotic therapy and prevention of thrombosis， 9th ed：American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J]. Chest， 2012， 141(2 Suppl)：7S-47S.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Clinical Report on Lower Limb Deep Venous Thrombosis Complicated with Pulmonary Embolism in 45 Cases

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