周围血管疾病急性深静脉血栓ppt课件

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1、PeripheralVascularDisease(周围血管疾病)PeripheralVascularDiseasePeripheralVascularDiseaseDiseasesofbloodvesselsoutsidetheheartandbrainDisordersoftheveinsPeripheralarterialdisease(PAD)PeripheralVascularDiseaseAcuteDeepVenousThrombosis急性深静脉血栓AcuteDeepVenousThrombosisVenousThromboembo

2、lism(VTE)Acutedeepvenousthrombosis(DVT)Pulmonaryembolism(PE)Post-thromboticsyndromeAcuteDeepVenousThrombosisRiskFactorsforAcuteDeepVenousThrombosis(DVT)andPulmonaryEmbolism(PE)RISKFACTORFORDVTORPEODDSRATIO95%CONFIDENCEINTERVALHospitalization:Withrecentsurgery21.729.44–49.93Wi

3、thoutrecentsurgery7.984.49–14.18Trauma12.694.06–39.66Malignantneoplasm:Withchemotherapy6.532.11–20.23Withoutchemotherapy4.051.93–8.52Priorcentralvenouscatheterorpacemaker5.551.57–19.58Priorsuperficialveinthrombosis4.321.76–10.61Neurologicdiseasewithextremityparesis3.041.25–7.

4、38Varicoseveins:Age45yr4.191.56–11.30Age60yr1.931.03–3.61Age75yr0.880.55–1.43Congestiveheartfailure:Thromboembolismnotcategorizedasacauseofdeathatpostmortem9.642.44–38.10Thromboembolismcategorizedasacauseofdeathatpostmortem1.360.69–2.68AcuteDeepVenousThrombosisRiskFactorsforA

5、cuteDeepVenousThrombosis(DVT)andPulmonaryEmbolism(PE)PrimaryHypercoagulableStatesPregnancyOralContraceptivesandHormonalTherapy…AcuteDeepVenousThrombosisSignsandsymptomsSymptomsAbsenceofsymptomsMassiveswellingCalfpain,edema,erythema,feverCyanosiswithimpendingvenousgangrene(phl

6、egmasiaceruleadolens，股青肿)SignsProminentsuperficialveinsHypertoniaandtendernessofcalfHomans’sign(painwithpassivedorsiflexionofthefoot)AcuteDeepVenousThrombosisVascularLabVenography(“goldstandard”,historically)DuplexUltrasonographyComputedtomographyvenography(CTV)D-DimerAssaysA

7、cuteDeepVenousThrombosisAscendingvenographyMay-ThurnersyndromeAcuteDeepVenousThrombosisDuplexUltrasonographySensitivity：97%Specificity：94%,Positivepredictivevalues：97%Negativepredictivevalues：98%,AcuteDeepVenousThrombosisDuplexUltrasonographyNormalThrombosedpoplitealveinAcute

8、DeepVenousThrombosisComputedtomographyvenography(CTV)AcuteDeepVenous