静脉血栓栓塞性疾病:流行病学、临床、准临床、治疗和进化方面:对伦敦大学内科和心内科112例患者7.5年的回顾性研究

Toure Ai, S. K, Boncano A, Dodo B, H. M, Haggar S, Z. À, Djonyony S
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摘要

引言:静脉血栓栓塞症(VTE)是世界上一个真正的公共卫生问题,因为其发生频率和严重程度,因为未经治疗的血栓栓塞事件的死亡率约为30%。由于其慢性和致残性并发症(血栓形成后疾病和慢性血栓栓塞性肺动脉高压),它是患者生活质量恶化的原因。目的:这项工作的目的是为阿米鲁·布巴卡尔·迪亚洛国立医院内科和心内科静脉血栓栓塞症的流行病学、临床、准临床、治疗和进化方面的研究做出贡献。患者和方法:这是一项从2019年7月1日至2020年6月30日的前瞻性研究,从2013年1月1日到2019年6月31日(7年零6个月)的回顾性研究,涉及112名诊断为深静脉血栓形成(DVT)和/或肺栓塞(PE)的患者。结果:在我们的研究中,静脉血栓栓塞症的患病率估计为心血管疾病住院患者的3.9%。患者以女性为主(性别比1.38),平均年龄52岁。长期卧床休息是常见的危险因素(66%)。临床症状主要是下肢水肿(83.3%)和肢体触诊疼痛(82.1%)(DVT),呼吸困难(23.02%)和胸痛(11.6%)(PE)。主要是左下肢发作(45.5%)。窦性心动过速(25.9%)是心电图的主要电征。下肢多普勒检查,腘静脉和股静脉受累最多,分别占22.3%和17.8%。根据胸部血管CT检查,100%的病例左肺动脉阻塞。该治疗基本上由低分子量肝素(90.1%)快速替换为维生素k拮抗剂(从肝素治疗的第一天开始)和/或普通肝素(9%)制成。最常见的并发症是DVT引起的PE,总死亡率为12.5%。结论:VTE是年轻人和老年人的病理学,其特征是在静脉中形成凝块,导致后者阻塞,导致局部炎症体征和/或其肺部迁移,这可能是致命的。VTE的预防和治疗是以抗凝血剂为基础的。
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Venous Thromboembolic Diseases: Epidemiological, Clinical, Para clinical, Therapeutic and Evolutionary Aspects: Retrospective Study over a Period of 7.5 Years about 112 Cases collected in the Internal Medicine and Cardiology Department of Lnth
Introduction: venous thromboembolism (VTE) is a real public health problem in the world due to its frequency and severity since the mortality from an untreated thromboembolic episode is around 30%. Because of its chronic and disabling complications (post-thrombotic disease and chronic thromboembolic pulmonary hypertension), it is responsible for a deterioration in the quality of life of patients. Objective: The aim of this work was to contribute to the study of the epidemiological , clinical, Para clinical, therapeutic and evolutive aspects of venous thromboembolism disease in the internal medicine and cardiology department of the Amirou Boubacar Diallo National Hospital. Patients and Methods: It's a prospective study from July 1st, 2019 to June 30th, 2020 and retrospective from January 1st, 2013 to June 30th, 2019 (7 years and 6 months) about 112 patients with whom the diagnostic of deep venous thrombosis (DVT ) and / or pulmonary embolism (PE) had been done. Results: In our study, the prevalence of venous thromboembolism has been estimated at 3.9% of hospitalized patients with cardiovascular diseases. There was a female predominance (sex ratio 1.38). The average age of patients was 52 years. Teabed-rest prolonged was the frequent risk factor (66%). The clinical symptomatology was dominated by oedema of the lower limb (83.3%) and pain in limb palpation (82.1%) in case of DVT, the dyspnea (23.02%) and thoracic pain (11.6%) in case of PE. The attack of the left lower limb prevailed (45.5%). The sinus tachycardia (25.9%) was the predominant electrical sign at the ECG. Through the Doppler of the lower limbs, the popliteal and femoral veins were the most involved with 22.3% and 17.8% respectively. According to the chest angio-CT, the left pulmonary artery was obstructed in 100% of case. The treatment was essentially made of low molecular weight heparins (90.1%) replaced quickly by vitamin k antagonist (began the first day of the heparin therapy) and / or of unfractionated heparin (9%). The most common complication was PE due to DVT and the overall mortality was 12.5%. Conclusion: VTE is pathology in young adults and elderly characterized by the formation of a clot in a vein responsible for the obstruction of the latter causing local inflammatory signs and / or its pulmonary migration which could be fatal. The prevention and treatment of VTE are based on anticoagulants.
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