Deep-vein-thrombosis深静脉血栓VIP专享VIP免费

DeepveinthrombosisXiangYuCheng第一页，共四十六页。WhatIsDeepVeinThrombosis?TheearliestcaseofDVTwasdescribedaround600-900BC.Atsomepoint,theincreasedincidenceofDVTinwomenafterchildbirthwasnoticed,andinthelate1700s,apublichealthrecommendationwasissuedtoencouragewomentobreastfeedasameanstopreventthisphenomenon;theDVTwascalled"milkleg",asitwasthoughttoresultfrommilkbuildingupintheleg.第二页，共四十六页。WhatIsDeepVeinThrombosis?Deepveinthrombosis,orDVT,isabloodclotthatformsinaveindeepinthebody.Bloodclotsoccurwhenbloodthickensandclumpstogether.第三页，共四十六页。WhatIsDeepVeinThrombosis?Abloodclotinadeepveincanbreakoffandtravelthroughtheblood.Theemboluscouldtraveltoanarteryinthelungsandblockbloodflow.Thisconditioniscalledpulmonaryembolism,orPE.第四页，共四十六页。EpidemiologyDeepveinthrombosis*DiagnosesofDVTandPEarenotmutuallyexclusive;anestimated78,511patientsreceiveddiagnosesofbothDVTandPE.VTEestimatesincludepatientswithdiagnosesofeitherDVTorPE.第五页，共四十六页。EpidemiologyDeepveinthrombosisAccordingtothemostrecentACCPguidelines,VTEremainsthesecondmostcommoncauseofprotractedhospitalstayandthethirdmostcommoncauseofexcessmortalityamong7millionpatientsdischargedfrom944acutecarehospitalsintheUS.第六页，共四十六页。CausesGermanpathologistRudolfVirchowpostulatedtheinterplayofthreeprocessesresultinginvenousthrombosis,nowknownasVirchow'striad:DeepveinthrombosisInkeepingwithVirchow'sconcept,alterationsofthecoagulationsystemthatinduceahypercoagulablestatealsoconferanincreasedriskofDVT.第七页，共四十六页。CausesGermanpathologistRudolfVirchowpostulatedtheinterplayofthreeprocessesresultinginvenousthrombosis,nowknownasVirchow'striad:Deepveinthrombosis第八页，共四十六页。CausesThebloodflowpatterninthevalvescancausehypoxemia,whichisworsenedbyvenousstasis,activatespathways-onesthatincludehypoxia-induciblefactor-1andearly-growth-responseprotein1.Hypoxia-induciblefactor-1andearly-growth-responseprotein1contributetomonocyteassociationwithendothelialproteins,suchasP-selectin,promptingmonocytestoreleasetissuefactor-filledmicrovesicles,whichpresumablybeginclottingafterbindingtotheendothelialsurface.[9]Deepveinthrombosis第九页，共四十六页。CausesIndependentRiskFactorsforDVTAgeisanindependentriskfactorforthromboticdisease.Themajorityofvenousthrombioccurineitherthesuperficialordeepveinsoftheleg.ADVTisstationaryclottingbloodadheredtothedeepveinofthepelvisoranextremityandusuallyoccursinthecalforthigh.VTEdenotesanobstructionarisingfromtheformationofaclotinthevenouscirculationcarriedbythebloodfromthesiteoforigintopluganothervessel.Deepveinthrombosis第十页，共四十六页。CausesIndependentRiskFactorsforDVTDeepveinthrombosis第十一页，共四十六页。SignsandsymptomsCommonsignsandsymptomsofDVTinclude：√Pain…√Swelling…√Warmth…√Rednessordiscoloration…√Distentionofsurfaceveins…Deepveinthrombosis第十二页，共四十六页。SignsandsymptomsCommonsignsandsymptomsofDVTinclude：√Pain…√Swelling…√Warmth…√Rednessordiscoloration…√Distentionofsurfaceveins…Deepveinthrombosis第十三页，共四十六页。SignsandsymptomsInmostsuspectedcases,DVTisruledoutafterevaluation,andsymptomsaremoreoftenduetoothercauses,suchascellulitis,Baker'scyst,musculoskeletalinjury,orlymphedema.Otherdifferentialdiagnosesincludehematoma,tumors,venousorarterialaneurysms,andconnectivetissuedisorders.Deepveinthr...