PeripheralVascularDisease

(周圍血管疾病)PeripheralVascularDisease第1頁(yè)，共20頁(yè)。PeripheralVascularDiseaseDiseasesofbloodvesselsoutsidetheheartandbrainDisordersoftheveinsPeripheralarterialdisease(PAD)

PeripheralVascularDisease第2頁(yè)，共20頁(yè)。AcuteDeepVenousThrombosis急性深靜脈血栓AcuteDeepVenousThrombosis第3頁(yè)，共20頁(yè)。VenousThromboembolism(VTE)Acutedeepvenousthrombosis(DVT)Pulmonaryembolism(PE)Post-thromboticsyndromeAcuteDeepVenousThrombosis第4頁(yè)，共20頁(yè)。RiskFactorsforAcuteDeepVenousThrombosis(DVT)andPulmonaryEmbolism(PE)

AcuteDeepVenousThrombosis第5頁(yè)，共20頁(yè)。RiskFactorsforAcuteDeepVenousThrombosis(DVT)andPulmonaryEmbolism(PE)PrimaryHypercoagulableStatesPregnancyOralContraceptivesandHormonalTherapy…AcuteDeepVenousThrombosis第6頁(yè)，共20頁(yè)。SignsandsymptomsSymptomsAbsenceofsymptomsMassiveswellingCalfpain,edema,erythema,feverCyanosiswithimpendingvenousgangrene(phlegmasiaceruleadolens，股青腫)SignsProminentsuperficialveinsHypertoniaandtendernessofcalfHomans’sign(painwithpassivedorsiflexionofthefoot)AcuteDeepVenousThrombosis第7頁(yè)，共20頁(yè)。VascularLabVenography(“goldstandard”,historically)DuplexUltrasonographyComputedtomographyvenography(CTV)D-DimerAssaysAcuteDeepVenousThrombosis第8頁(yè)，共20頁(yè)。AscendingvenographyMay-ThurnersyndromeAcuteDeepVenousThrombosis第9頁(yè)，共20頁(yè)。DuplexUltrasonographySensitivity：97%Specificity：94%,Positivepredictivevalues：97%Negativepredictivevalues：98%,AcuteDeepVenousThrombosis第10頁(yè)，共20頁(yè)。DuplexUltrasonographyNormalThrombosedpoplitealveinAcuteDeepVenousThrombosis第11頁(yè)，共20頁(yè)。Computedtomographyvenography(CTV)AcuteDeepVenousThrombosis第12頁(yè)，共20頁(yè)。D-DimerAssaysElevatedD-dimervaluesareassociatedwith：Thrombosis（sensitivity96.8%）DICMalignancyPostoperativestatesPreeclampsiaInfectionRecenttraumaAcuteDeepVenousThrombosis第13頁(yè)，共20頁(yè)。PreventionofVenousThromboembolismLow-molecular-weightheparin(LMWH)IntermittentpneumaticlegcompressionGraduated-CompressionStockingsOralAnticoagulantsAcuteDeepVenousThrombosis第14頁(yè)，共20頁(yè)。TreatmentAnticoagulantTherapyThrombolytictreatmentInpatientswithDVT,werecommendagainsttheroutineuseofIVthrombolytictreatment(Grade1A)IVCfilterplacementFormostpatientswithDVT,werecommendagainst

theroutineuseofavenacavafilterinadditiontoanticoagulants(Grade1A)EighthACCPConferenceonAntithromboticandThrombolyticTherapy，2008AcuteDeepVenousThrombosis第15頁(yè)，共20頁(yè)。AnticoagulantTherapyforVTEObjectivesoftreatmentinpatientswithVTEare:

TopreventdeathfromPETopreventrecurrentVTETopreventthepost-thromboticsyndromeAcuteDeepVenousThrombosis第16頁(yè)，共20頁(yè)。AnticoagulantTherapyforVTEAnticoagulantdrugsHeparin(100U/kgbodyweight,SC,q12h)LMWH(0.1ml/10kgbodyweight,SC,q12h)Warfarin(KeepINR2.0-3.0)AcuteDeepVenousThrombosis第17頁(yè)，共20頁(yè)。ContraindicationsofAnticoagulantTherapyPatientswhohaveundergonesurgerywithintheprevious2weeksPatientswithaprevioushistoryofpepticulcerdiseaseorgastrointestinalorgenitourinarybleeding.Patientswithrecentstroke(i.e.,thromboticstrokewithin2weekspreviously)Patientswithaplateletcount<150×109/LPatientswithmiscellaneousreasonsforahighriskofbleeding(e.g.,hepaticfailure,renalfailure,orvitaminKdeficiency)AcuteDeepVenousThrombosis第18頁(yè)，共20頁(yè)。PEandInferiorvenacavafilterAcuteDeepVenousThrombosis第19頁(yè)，共20頁(yè)。內(nèi)容梗概PeripheralVascularDisease

(周圍血管疾病)。PeripheralVascularDisease

(周圍血管疾病)。AcuteDeepVenousThrombosis。Pulmonaryembolism(PE)。Prominentsuperficialveins。Venography(“goldstandard”,historically)。Computedtomographyvenography(CTV)。Negativepredictivevalues：