Deep vein thrombosis of the upper limb is a rare location of venous thromboembolic disease. Data on this form of thrombosis are limited. We report six cases collected in Dakar. The sex ratio was 0.5 and the average ag...Deep vein thrombosis of the upper limb is a rare location of venous thromboembolic disease. Data on this form of thrombosis are limited. We report six cases collected in Dakar. The sex ratio was 0.5 and the average age was 27.6 years with extremes of 17 and 39. Painful limb edema was the most constant sign and involved the non-dominant limb in almost all patients. Thrombosis occurred in a field of peripartum cardiomyopathy in two patients and SS sickle cell disease in one patient taking oral contraception. There was neither cancer nor venous catheter in medical history. The diagnosis was made by venous Doppler ultrasound in all patients. Subclavian involvement was the most common. The thrombophilia assessment, done for two patients, was normal. It was about exertion thrombosis on three (3) patients. All the patients had received antivitamin K treatment relaying a low molecular weight heparin. Venous limb compression was associated with anticoagulation for all patients. The treatment duration was six (6) months. There were no reports of pulmonary embolism or death. One patient presented a post-thrombotic syndrome.展开更多
Deep vein thrombosis (DVT) is one or more blood clots formed inside the deep vein in the body resulting in complete or partial blockage of blood flow through the affected vein. Upper Extremity DVT (UEDVT) accounts for...Deep vein thrombosis (DVT) is one or more blood clots formed inside the deep vein in the body resulting in complete or partial blockage of blood flow through the affected vein. Upper Extremity DVT (UEDVT) accounts for 5% - 10% of all cases of DVTs. Previously it was thought to be a rare disorder. However in recent years with the advent of various indwelling intravenous devices, hypercoagulable state like COVID-19, secondary UEDVT did not remain infrequent presentation anymore. Though primary UEDVT, also known as Effort Thrombosis, that takes place without any underlying obvious pathology is a rare form till now. We presented a case of 46 years female who presented to the emergency with complaints of progressively increasing pain (7 days) and swelling (3 days) of her right forearm since last 7 days following strenuous and heavy work by her dominant/ right hand during the period of festival. She initially ignored her condition because of the Durga Puja festival. As her symptoms deteriorated she eventually had to attend the emergency department. Eventually an urgent ultrasonography color Doppler was done on emergency basis which diagnosed underlying DVT of her right brachial vein. She was managed with low molecular weight heparin, urgent fasciotomy owning to her impending compartment syndrome. Other tests ruled out any secondary underlying pathology. She improved and discharged without any complications on oral anticoagulant. Exigent events in her history were trauma followed by fall on her right elbow 2 months back and then presenting signs & symptoms commencing at the same region following strenuous, tedious activities over 7 days and consequential effort thrombosis of her right brachial vein. All of that compelled us to ruminate on rare differentials of her presentation and eventually come to this rare diagnosis. The author hence brought this pedagogic case to the readers, especially emergency & primary care physicians and emphasised the importance of being intuitive about rare but deadly differentials which come展开更多
目的探讨精细化护理在乳腺癌经外周静脉置中心静脉导管(Peripherally Inserted Central Venous Catheter,PICC)置管化疗患者中的应用及对导管相关性上肢深静脉血栓(Catheter Related Deep Venous Thrombosis of Upper Extremity,UEDVT)...目的探讨精细化护理在乳腺癌经外周静脉置中心静脉导管(Peripherally Inserted Central Venous Catheter,PICC)置管化疗患者中的应用及对导管相关性上肢深静脉血栓(Catheter Related Deep Venous Thrombosis of Upper Extremity,UEDVT)的预防效果。方法单纯随机选取2021年10月—2023年7月福建省三明市第二医院行PICC置管化疗的90例乳腺癌患者为研究对象,以随机数表法为依据分为两组,对照组(45例)实施常规护理,观察组(45例)基于对照组实施精细化护理,比较两组的UEDVT及其他置管事件发生情况、干预前后的腋下血液流速、血栓弹力图(Thromboelastography,TEG)参数以及生活质量。结果观察组UEDVT及其他置管事件的发生率(2.22%和4.44%)均低于对照组(17.78%和17.78%),差异有统计学意义(χ^(2)=4.444、4.050,P均<0.05)。干预后,观察组两项腋下血液流速指标(最大血液流速与静脉平均血液流速)均快于对照组,差异有统计学意义(P均<0.05)。干预后,观察组TEG参数中的R值高于对照组,MA值低于对照组,差异有统计学意义(P均<0.05)。干预后,观察组生活质量评分量表中的环境、社会、生理及心理得分均高于对照组,差异有统计学意义(P均<0.05)。结论精细化护理能够有效改善乳腺癌PICC置管化疗患者的腋下血液流速,预防UEDVT及其他置管事件发生,提升患者置管期间的生活质量。展开更多
文摘Deep vein thrombosis of the upper limb is a rare location of venous thromboembolic disease. Data on this form of thrombosis are limited. We report six cases collected in Dakar. The sex ratio was 0.5 and the average age was 27.6 years with extremes of 17 and 39. Painful limb edema was the most constant sign and involved the non-dominant limb in almost all patients. Thrombosis occurred in a field of peripartum cardiomyopathy in two patients and SS sickle cell disease in one patient taking oral contraception. There was neither cancer nor venous catheter in medical history. The diagnosis was made by venous Doppler ultrasound in all patients. Subclavian involvement was the most common. The thrombophilia assessment, done for two patients, was normal. It was about exertion thrombosis on three (3) patients. All the patients had received antivitamin K treatment relaying a low molecular weight heparin. Venous limb compression was associated with anticoagulation for all patients. The treatment duration was six (6) months. There were no reports of pulmonary embolism or death. One patient presented a post-thrombotic syndrome.
文摘Deep vein thrombosis (DVT) is one or more blood clots formed inside the deep vein in the body resulting in complete or partial blockage of blood flow through the affected vein. Upper Extremity DVT (UEDVT) accounts for 5% - 10% of all cases of DVTs. Previously it was thought to be a rare disorder. However in recent years with the advent of various indwelling intravenous devices, hypercoagulable state like COVID-19, secondary UEDVT did not remain infrequent presentation anymore. Though primary UEDVT, also known as Effort Thrombosis, that takes place without any underlying obvious pathology is a rare form till now. We presented a case of 46 years female who presented to the emergency with complaints of progressively increasing pain (7 days) and swelling (3 days) of her right forearm since last 7 days following strenuous and heavy work by her dominant/ right hand during the period of festival. She initially ignored her condition because of the Durga Puja festival. As her symptoms deteriorated she eventually had to attend the emergency department. Eventually an urgent ultrasonography color Doppler was done on emergency basis which diagnosed underlying DVT of her right brachial vein. She was managed with low molecular weight heparin, urgent fasciotomy owning to her impending compartment syndrome. Other tests ruled out any secondary underlying pathology. She improved and discharged without any complications on oral anticoagulant. Exigent events in her history were trauma followed by fall on her right elbow 2 months back and then presenting signs & symptoms commencing at the same region following strenuous, tedious activities over 7 days and consequential effort thrombosis of her right brachial vein. All of that compelled us to ruminate on rare differentials of her presentation and eventually come to this rare diagnosis. The author hence brought this pedagogic case to the readers, especially emergency & primary care physicians and emphasised the importance of being intuitive about rare but deadly differentials which come
文摘目的探讨精细化护理在乳腺癌经外周静脉置中心静脉导管(Peripherally Inserted Central Venous Catheter,PICC)置管化疗患者中的应用及对导管相关性上肢深静脉血栓(Catheter Related Deep Venous Thrombosis of Upper Extremity,UEDVT)的预防效果。方法单纯随机选取2021年10月—2023年7月福建省三明市第二医院行PICC置管化疗的90例乳腺癌患者为研究对象,以随机数表法为依据分为两组,对照组(45例)实施常规护理,观察组(45例)基于对照组实施精细化护理,比较两组的UEDVT及其他置管事件发生情况、干预前后的腋下血液流速、血栓弹力图(Thromboelastography,TEG)参数以及生活质量。结果观察组UEDVT及其他置管事件的发生率(2.22%和4.44%)均低于对照组(17.78%和17.78%),差异有统计学意义(χ^(2)=4.444、4.050,P均<0.05)。干预后,观察组两项腋下血液流速指标(最大血液流速与静脉平均血液流速)均快于对照组,差异有统计学意义(P均<0.05)。干预后,观察组TEG参数中的R值高于对照组,MA值低于对照组,差异有统计学意义(P均<0.05)。干预后,观察组生活质量评分量表中的环境、社会、生理及心理得分均高于对照组,差异有统计学意义(P均<0.05)。结论精细化护理能够有效改善乳腺癌PICC置管化疗患者的腋下血液流速,预防UEDVT及其他置管事件发生,提升患者置管期间的生活质量。
