Early diagnosis of lower extremity deep venous thrombosis and therapeutic effect of anticoagulation therapy with Roberts' age adjusted warfarin loading protocol in patients with acute ischemic stroke
10.3760/cma.j.issn.0254-9026.2009.02.033
- VernacularTitle:急性脑梗死患者下肢深静脉血栓的诊断及华法林抗凝治疗的疗效和安全性
- Author:
Weiliang LUO
;
Wu LIU
;
Jinhua QIU
;
Nanyan XU
;
Caiming LI
;
Hong WEN
- Publication Type:Journal Article
- Keywords:
Venous thrombosis;
Brain infarction;
Anticoagulans;
Warfarin
- From:
Chinese Journal of Geriatrics
2009;28(2):104-108
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the early diagnosis of lower extremity deep venous thrombosis (LDVT)and evaluate the therapeutic effect of anticoagulant therapy in hospitalized patients with acute ischemic stroke. Methods According to Wells model for suspecting lower extremity deep venous thrombosis,patients with suspected LDVT were confirmed by compression ultrasonography. If the patients diagnosed with LDVT had no contraindications to anticoagulant therapy,they were treated with low molecular weight heparin(LMWH)subcutaneous injection and oral warfarin at the same time.The dosage of oral warfarin was determined by Roberts'age adjusted warfarin loading protocol.LMWH was stopped when the patients'international normalized ratio(INR)was 2.0～3.0 for two consecutive days. Results From January 2003 to August 2007,2067 cases with acute ischemic stroke were admitted to the department of neurology in Huizhou Municipal Central Hospital including 18 cases with LDVT and the incidence was 0.9%.The patients with LDVT all had paralytic extremities including 13 left legs and 5 right legs with deep vein thrombosis.All the 18 cases were treated by anticoagulant including 17 cases with oral warfarin treatment for 3 months.Symptoms in all LDVT patients were eliminated.12 cases had been observed for one year and 5 cases for three months after they stopped taking warfatin.There were no patients with pulmonary thromboembolism and LDVT recurrence. Conclusions By using Wells model for suspecting LDVT,patients with acute ischemic stroke-complicated LDVT can be timely diagnosed.The goal of prompt and enough anticoagulant can be achieved according to Roberts'age adjusted warfarin loading protocol.Because of racial difference,population difference and other unknown factors,the incidence of acute ischemic stroke patients with complicated LDVT is much lower in Huizhou.It suggests that it should be unnecessary to use LMWH in patients with acute ischemic stroke to prevent LDVT in Huizhou.
