scholarly journals Nursing Intervention Countermeasures of Robot-Assisted Laparoscopic Urological Surgery Complications

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xushu An ◽  
Jinyuan Zhou ◽  
Xuenan Ma ◽  
Bingbing Song
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Laparoscopic Surgery ◽  
Lower Limb ◽  
Nursing Intervention ◽  
Control Group ◽  
Observation Group ◽  
Robot Assisted ◽  
Vein Thrombosis ◽  
Deep Vein

The objective is to explore the application effect of comprehensive nursing intervention in prevention of lower extremity deep vein thrombosis and pulmonary embolism in urological patients undergoing laparoscopic and robot-assisted laparoscopic surgery. From April 2019 to April 2020, 200 patients who received urological laparoscopic surgery and robot-assisted laparoscopic surgery were selected. According to the random number table method, they were divided into control group and observation group, 100 cases in control group and 100 cases in observation group. Patients in control group received routine nursing, while patients in observation group received comprehensive nursing intervention. The skin condition, swelling, pain, and occurrence of deep venous thrombosis and pulmonary embolism of lower extremities in 2 groups were observed. The experimental results showed that the lower limb swelling, lower limb pain, and lower limb deep vein thrombosis in the control group were significantly higher than those in the observation group, but all patients were cured and discharged after taking effective symptomatic treatment and nursing measures in time. In the control group, pulmonary embolism occurred in 3 patients, all of whom died. There was no significant difference in skin changes of lower limbs ( P > 0.05 ), and there were significant differences in other skin changes ( P < 0.05 ). It proved that comprehensive nursing intervention can effectively prevent the formation of lower extremity deep vein thrombosis and pulmonary embolism in urological patients undergoing laparoscopic and robot-assisted laparoscopic surgery with high-risk factors.

Controlled Trial of the Sequential Use of Streptokinase and Ancrod in the Treatment of Deep Vein Thrombosis of Lower Limb

1977 ◽  
Vol 37 (02) ◽  
pp. 222-232 ◽  
Author(s):  
D. A Tibbutt ◽  
C. N Chesterman ◽  
E. W Williams ◽  
T Faulkner ◽  
A. A Sharp
Keyword(s):  
Deep Vein Thrombosis ◽  
Clinical Improvement ◽  
Anticoagulant Therapy ◽  
Lower Limb ◽  
Oral Anticoagulant ◽  
Controlled Trial ◽  
Oral Anticoagulant Therapy ◽  
Control Group ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryTreatment with streptokinase (‘Kabikinase’) was given to 26 patients with venographically confirmed deep vein thrombosis extending into the popliteal vein or above. Treatment was continued for 4 days and the patients were allocated randomly to oral anticoagulant therapy or a course of treatment with ancrod (‘Arvin’) for 6 days followed by oral anticoagulant therapy. The degree of thrombolysis as judged by further venographic examination at 10 days was not significantly different between the 2 groups. The majority of patients showed clinical improvement but there was no appreciable difference between the groups at 3 and 6 months. Haemorrhagic complications were a more serious problem during the period of treatment with ancrod than during the equivalent period in the control group.

scholarly journals Comparison of the Effects of Epidural Anesthesia and General Anesthesia on Perioperative Cognitive Function and Deep Vein Thrombosis in Patients Undergoing Total Knee Arthroplasty

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Zhenyu Wu ◽  
Yan Zhu
Keyword(s):  
Total Knee Arthroplasty ◽  
Deep Vein Thrombosis ◽  
General Anesthesia ◽  
Epidural Anesthesia ◽  
Control Group ◽  
Observation Group ◽  
Vein Thrombosis ◽  
Significant Difference ◽  
Total Knee ◽  
Deep Vein

Objective. To explore the effects of epidural anesthesia and general anesthesia on perioperative cognitive function and deep vein thrombosis (DVT) in patients undergoing total knee arthroplasty (TKA). Methods. Total of 68 patients undergoing TKA in our hospital from September 2019 to March 2021 were selected and divided into the control group under general anesthesia and the observation group under epidural anesthesia according to the different anesthesia methods, 34 patients in each group. TKA was selected in both groups and performed by the same group of physicians, anesthesiologists, and nursing staff. The mean arterial pressure (MAP), heart rate (HR), and blood oxygen saturation (SpO2) were observed immediately before anesthesia (T1), 30 min after anesthesia (T2), after surgery (T3), and 1 d after surgery (T4). The changes of platelet (PLC), fibrinogen (Fbg), prothrombin time (PT), activated partial thrombin time (APTT), and other coagulation indicators were recorded. The Montreal Cognitive Assessment (MoCA) scores before surgery and 1 d and 3 d after surgery were observed. The blood samples of the two groups were collected before surgery and 1 d and 3 d after surgery, and the levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in the peripheral blood of the two groups were measured by ELISA. The number of postoperative mental disorders and DVT in the two groups was calculated. Results. The MAP and HR of T4 were lower than those of T1, T2, and T3. The MAP of T2, T3, and T4 in the observation group was lower than that in the control group ( P < 0.05 ), and the SpO2 of T1–T4 in the two groups did not change significantly, and there was no significant difference between the two groups ( P > 0.05 ). Compared with T1, there was no significant difference in PLC, Fbg, and PT in the observation group T4 ( P > 0.05 ), and APTT was lower than T1 ( P < 0.05 ). The PLC, PT, and APTT of T4 in the control group were all lower than those of T1 ( P < 0.05 ), and there was no significant difference between Fbg and T1 ( P > 0.05 ). The PLC, Fbg, and PT of T4 in the observation group were higher than those in the control group, while APTT was lower than that in the control group ( P < 0.05 ). The MoCA scores of patients in both groups on the 1st and 3rd day after operation were lower than those before operation, and the observation group was higher than that in the control group ( P < 0.05 ). The BDNF and NGF of patients in both groups were lower than those before operation on the 1st day after operation, and the BDNF and NGF in the observation group were higher than those in the control group on the 1st and 3rd day after operation ( P < 0.05 ). The mental disorder (2.94%) and DVT incidence (2.94%) in the observation group were lower than those in the control group (29.41%, 26.47%) ( P < 0.05 ). Conclusion. Epidural anesthesia for patients with TKA can obtain better clinical effects, maintain stable hemodynamic and coagulation states, reduce stress response of patients at the same time, and reduce perioperative cognitive dysfunction and the incidence of DVT in patients.

scholarly journals Acute pulmonary embolism complicating deep vein thrombosis in a young patient with stroke

2021 ◽  
Vol 11 (2) ◽  
pp. 142-144
Author(s):  
Mohammed Mirazur Rahman ◽  
Farjana Binte Habib ◽  
Ahmed Imran Kabir ◽  
Samprity Islam ◽  
Rajashish Chakrabortty ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Acute Pulmonary Embolism ◽  
Successful Outcome ◽  
Shortness Of Breath ◽  
Vein Thrombosis ◽  
Doppler Study ◽  
Left Lower Limb ◽  
Deep Vein

Acute pulmonary embolism is one of the most common causes of vascular death after myocardial infarction and cerebrovascular accidents. It usually presents with severe chest pain and shortness of breath and occasionally occurs in the background of deep vein thrombosis. A 32-year-old male presented with swelling of left lower limb and shortness of breath. Subsequent investigations revealed that he developed DVT of left lower limb and pulmonary embolism. However, in general, if left untreated, pulmonary embolism is associated with an overall mortality of up to 30 percent compared with 2 to 11 percent in those treated with anticoagulation. Early diagnosis by D-dimer, computed tomograpgy pulmonary angiogram and doppler study of the left lower limb and prompt intervention through low molecular weight heparin and rivaroxaban led to a successful outcome in our case. Birdem Med J 2021; 11(2): 142-144

The risk of postoperative hemorrhage and efficacy of heparin for preventing deep vein thrombosis and pulmonary embolism in adult patients undergoing neurosurgery: a systematic review and meta-analysis

2017 ◽  
Vol 65 (8) ◽  
pp. 1136-1146 ◽  
Author(s):  
Xuan Wang ◽  
Ying-Chun Zhou ◽  
Wen-De Zhu ◽  
Yun Sun ◽  
Peng Fu ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Meta Analysis ◽  
Postoperative Bleeding ◽  
Postoperative Hemorrhage ◽  
Adult Patients ◽  
Control Group ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Heparin Prophylaxis

The aim of this meta-analysis was to examine the risk of postoperative bleeding and efficacy of heparin for preventing deep vein thrombosis (DVT) and pulmonary embolism (PE) in adult patients undergoing neurosurgery. MEDLINE, Cochrane, and EMBASE databases were searched until October 31, 2016, for randomized controlled trials (RCTs) and non-randomized comparative studies that assessed the rates of postoperative hemorrhage, DVT, PE, and mortality in adult patients undergoing neurosurgery. Nine eligible studies (five RCTs, four retrospective studies) including 874 patients treated with either unfractionated heparin (UFH) or low-molecular-weight heparin (LMWH) and 1033 patients in control group (placebo with or without compression device) were analyzed. The overall analysis revealed that there was an increase in the risk of postoperative hemorrhage in patients who received heparin (pooled OR 1.66, 95% CI 1.01 to 2.72, p=0.046) compared with no treatment group. The risk of postoperative hemorrhage was more significant if only RCTs were included in analysis. Heparin prophylaxis was associated with a decrease in the risk of DVT (pooled OR 0.48, 95% CI 0.36 to 0.65, p<0.001) and PE (pooled OR 0.25, 95% CI 0.09 to 0.73, p=0.011) but it did not affect the rate of mortality. In conclusion, heparin increased the rate of postoperative bleeding, decreased the risk of DVT, PE and venous thromboembolic event (VTE) but it did not affect the mortality of patients undergoing neurosurgery. For the heparin prophylaxis, the trade-off between the risk of postoperative bleeding and benefit of prophylaxis against VTEs requires further investigation.

Bed Rest in Deep Vein Thrombosis and the Incidence of Scintigraphic Pulmonary Embolism

1999 ◽  
Vol 82 (S 01) ◽  
pp. 127-129 ◽  
Author(s):  
Thomas Schwarz ◽  
Joachim Kropp ◽  
Yvette Prescher ◽  
Bettina Beuthien-Baumann ◽  
Werner G. Daniel ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Treatment Group ◽  
Bed Rest ◽  
Compression Therapy ◽  
Control Group ◽  
P Value ◽  
Theoretical Assumption ◽  
Vein Thrombosis ◽  
Deep Vein

SummaryIn several countries of central Europe, patients with acute proximal deep vein thrombosis (DVT) are treated not only by anticoagulation and compression therapy but additionally by strict bed rest for 6-8 days. Until now the theoretical assumption that bed rest substantially reduces the incidence of pulmonary embolism has not been subjected to empirical verification. Patients with acute proximal DVT proven by ultrasonography were randomly assigned to strict bed rest for 8 days (treatment group) or to stay mobilised (control group). In both groups, basic treatment consisted in anticoagulation by subcutaneous low molecular weight heparin/vitamin-K-antagonist and compression therapy. The incidence of pulmonary embolism was assessed by serial ventilation/perfusion SPECT on day 1 and days 8-10. Of the 309 patients with proximal DVT considered for inclusion, 180 were excluded according to the study protocol, and 3 did not give informed consent. One hundred and twenty-six patients were randomly assigned to observe bed rest (n = 62) or to keep mobilised (n = 64). Four patients refused follow-up lung scan.A new lung perfusion defect was detected in 10/59 patients in the treatment group compared to 14/63 patients in the control group (one-sided p-value = 0.25; power 0.8). Bed rest as an additional measure in the treatment of DVT is not able to substantially reduce the incidence of scintigraphically detectable pulmonary embolism. The discomfort and costs associated with the prescription of bed rest in DVT are obviously inappropriate.

scholarly journals Giant Lower Limb Myxoid Liposarcoma Causing Deep Vein Thrombosis, Complicated with Pulmonary Embolism Case Report

2019 ◽  
Vol 25 (1) ◽  
pp. 31-35
Author(s):  
Kaller Reka ◽  
Hălmaciu Ioana ◽  
Suciu Bogdan Andrei ◽  
Alexandru Strat ◽  
Toma Lucian ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Soft Part ◽  
Surgical Excision ◽  
Myxoid Liposarcoma ◽  
Shortness Of Breath ◽  
Vein Thrombosis ◽  
Deep Vein ◽  
Histologic Subtypes

Abstract Liposarcoma (LPS) is one of the most common histologic subtypes of adult soft tissue sarcoma. Here, we report the case of a 52-year-old woman complaining of shortness of breath, chest pain, painful leg swelling 24 hour before presentation at our institution. Despite a vascular, soft part ultrasound and CTA, which suspected a voluminous haematoma, a huge tumour was found and a myxoid liposarcoma was identified by surgical excision and a histological examination, respectively.

scholarly journals May–Thurner Syndrome: A Consideration for Deep Vein Thrombosis in Males

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Tay Tian En Jason ◽  
Tay Jia Sheng ◽  
Tieng Chek Edward Choke ◽  
Pooja Sachdeva
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Lower Limb ◽  
Vena Cava ◽  
Postthrombotic Syndrome ◽  
Ivc Filter ◽  
Vein Thrombosis ◽  
Left Lower Limb ◽  
Deep Vein

May–Thurner syndrome (MTS) is an underdiagnosed cause of lower limb deep vein thrombosis (DVT). The clinical prevalence of MTS-related DVT is likely underestimated, particularly in patients with other more recognisable risk factors. MTS is classically described in females between the age group of 20–50 years. In patients with acute iliofemoral thrombosis, medical treatment with anticoagulation alone has been associated with higher risk of postthrombotic syndrome (PTS) and lower iliofemoral patency rates, as compared to endovascular correction. We describe a case of MTS-related extensive iliofemoral DVT occurring in a middle age male who presented with acute onset of left lower limb swelling and pain, complicated by pulmonary embolism. Doppler compression ultrasonography of the left lower limb showed partial DVT extending from the left external iliac to the popliteal veins, and contrasted computed tomography (CT) of the thorax abdomen and pelvis established features of MTS, together with right pulmonary embolism. He was started on low molecular weight heparin (LMWH) and then underwent left lower limb AngioJet pharmacomechanical thrombolysis/thrombectomy, iliac vein stenting, and temporary inferior vena cava (IVC) filter insertion. After the procedure, the patient recovered and improved symptomatically with rapid resolution of this left lower limb swelling and pain. He was switched to an oral Factor Xa inhibitor and was subsequently discharged. After 1-month follow-up, he remained well with stent patency visualised on repeat ultrasound and underwent an uneventful elective IVC filter retrieval with subsequent plans for a 1-year follow-up.

scholarly journals The frequencies of FV Leiden and FII G20210A mutations in patients with different clinical manifestations of venous thromboembolism: Experience from large Serbian cohort

Genetika ◽  
2016 ◽  
Vol 48 (2) ◽  
pp. 609-616
Author(s):  
Branko Tomic ◽  
Maja Gvozdenov ◽  
Iva Pruner ◽  
Mirjana Kovac ◽  
Nebojsa Antonijevic ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Venous Thromboembolism ◽  
Clinical Manifestations ◽  
Rflp Analysis ◽  
Control Group ◽  
Vein Thrombosis ◽  
G20210a Mutation ◽  
Fv Leiden ◽  
Deep Vein

Venous thromboembolism is a multifactorial disorder with two manifestations: deep-vein thrombosis and pulmonary embolism. Pulmonary embolism is usually considered as the complication of deep-vein thrombosis, but there are reported cases of isolated pulmonary embolism. FV Leiden and FII G20210A mutations are most common genetic risk factors for the venous thromboembolism. Several studies reported "FV Leiden paradox": lower prevalence of FV Leiden mutation among patients with isolated pulmonary embolism than among those with deep-vein thrombosis. The aim of this study was to determine FV Leiden and FII G20210A mutations frequency in thrombophilic patients in Serbian population. We tested prevalence of these mutations carriers in 1427 individuals divided in three groups of patients (with deep-vein thrombosis, deep-vein thrombosis/ pulmonary embolism and isolated pulmonary embolism) and control group. All subjects were tested for these mutations using PCR-RFLP analysis. Detected frequency of FV Leiden heterozygous carriers in patients with isolated pulmonary embolism was 6.9% (for FII G20210A 11.6%), while in other two groups of patients with deep-vein thrombosis and deep vein thrombosis/pulmonary embolism, frequency was 18.6% (for FII G20210A mutation were 11.6% and 8.3%, respectively). Our results showed that FV Leiden mutation is less frequent in patients with isolated pulmonary embolism than in patients with deep-vein thrombosis or deep-vein thrombosis accompanied with pulmonary embolism, confirming "FV Leiden paradox". On the other hand, detected frequency of FII G20210A mutation carriers was similar in all three groups of patients.

scholarly journals The Risk of Subsequent Deep Vein Thrombosis and Pulmonary Embolism in Patients with Nontyphoidal Salmonellosis: A Nationwide Cohort Study

2020 ◽  
Vol 17 (10) ◽  
pp. 3567
Author(s):  
Renin Chang ◽  
Den-Ko Wu ◽  
James Cheng-Chung Wei ◽  
Hei-Tung Yip ◽  
Yao-Min Hung ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Deep Vein Thrombosis ◽  
Proportional Hazards ◽  
Absolute Risk ◽  
Cox Proportional Hazards ◽  
Control Group ◽  
P Value ◽  
Vein Thrombosis ◽  
Increased Risk ◽  
Deep Vein

The purpose of this study was to evaluate the deep vein thrombosis (DVT) and pulmonary embolism (PE) risk among patients with a diagnosis of nontyphoidal salmonellosis (NTS) in an Asian population. The risk was analyzed in a cohort of 17,855 patients newly diagnosed with NTS and 71,420 individuals without NTS using a hospitalization claim dataset. Both groups were matched by age, sex, and index date as an original analysis. A Cox proportional-hazards regression model was applied to estimate the risk of DVT and PE, accounting for any competing event (death). With a follow-up of 4.94 (±3.93) years in the NTS group and 6.30 (±3.67) years in the non-NTS group, the adjusted subhazard ratios (SHRs) of DVT and PE were 1.83 (95% CI 1.44–2.31) and 1.84 (95% CI 1.30–2.60). The NTS group had an increased risk of DVT and PE compared with the control group in all of the age subgroups. Stratified analyses showed that patients aged 18–39 years in the NTS group had significantly higher DVT and PE risks compared with patients of the same age in the non-NTS group (aHR, 5.95; 95% CI, 2.22–15.91 for DVT; aHR 6.72; 95% CI, 2.23–20.30 for PE). The P-value for interaction between age and exposure of NTS is <0.001 for DVT and 0.004 for PE in our sub-group analyses. The findings were cross-validated by a re-analysis with propensity score matching (PSM), and that revealed consistent results. Despite of low absolute risk, clinicians should be aware that patients with an NTS hospitalization history is at increased risk for VTE especially when assessing patients coincident with other VTE risk factors.

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