Who is prone to pulmonary embolism?
As early as 1856, the German scholar Virchow described the three basic elements of thrombosis.
Blood flow stasis, hypercoagulable state and endothelial damage. These three elements are also the basic conditions for the development of pulmonary embolism. What are the three conditions that occur in daily life? First of all, stagnant blood flow is mainly seen in people who are less active or even inactive, such as sedentary people, as mentioned above “economy class syndrome”, while pulmonary embolism caused by prolonged use of computer, playing mahjong or watching TV is common in modern life. In addition, the braking state caused by some diseases, such as lower limb fracture, braking after various surgeries, braking caused by obesity, etc., are common clinical causes of pulmonary embolism.
Secondly, the hypercoagulable state mainly refers to the increased coagulation components in the blood under certain pathological or physiological conditions, which can be seen in.
1, malignant tumor: tumor combined with pulmonary embolism is not uncommon, and some tumor patients even have pulmonary embolism as the first manifestation.
2.Pregnancy and perinatal period: increased production of procoagulant factors and decreased fibrinolytic and anticoagulant activity in women during pregnancy and perinatal period, thus presenting a hypercoagulable state.
3, estrogen replacement therapy: may be used in menopausal women or women in menopause
4, some other disease states: such as lower extremity, knee, abdominal, or pelvic injuries or surgery, infectious bowel disease, nephrotic syndrome, and severe infection-induced sepsis.
5, hereditary thrombophilia: some anticoagulation and pro-coagulation factors are defective due to genetic mutations, causing imbalance of coagulation and fibrinolytic system. Again, endothelial injury, refers to the innermost layer of blood vessels (endothelial damage), so that the blood clotting components in this aggregation and the formation of thrombosis, can be seen in trauma, such as lower extremity injury can lead to endothelial damage, there have been cases of thrombosis secondary to lower extremity vascular injury due to high intensity fitness, in addition to endothelial injury can also be seen in the veins of some medical operations, such as intervention Endothelial damage can also be seen in intravenous medical procedures such as interventional procedures, venipuncture, chemical stimulation, central venous cannulation, and heart valve disease and replacement. These are the groups of people who are prone to pulmonary embolism. If these special groups of people have difficulty in breathing, chest pain, hemoptysis, or even syncope, it is recommended to consult a doctor promptly, except pulmonary embolism. With the awareness of diagnosis of pulmonary embolism, it is not difficult to diagnose and detect pulmonary embolism with the current medical level. The treatment of pulmonary embolism mainly includes thrombolysis and anticoagulation therapy, and anticoagulation therapy takes at least 3 to 6 months or longer, and some patients even have lifelong anticoagulation, so some details in daily life need special attention.
What should we pay attention to in anticoagulation therapy?
The main drugs used in anticoagulation therapy for pulmonary embolism are warfarin, low molecular heparin and some new oral anticoagulants, such as rivaroxaban and dabigatran. In the process of anticoagulation, it is necessary to pay attention to the appropriate amount of anticoagulation, which is not only adequate but also not excessive.
First, how to ensure adequate anticoagulation?
We have to do the following.
1, according to medical advice: the effective time of anticoagulant drugs in the body generally does not exceed one day, so in order to ensure effective and adequate anticoagulation, must be regular daily medication.
2, regular diet: because of the cheap and accurate effect, warfarin is still the first choice of most anticoagulation therapy, but warfarin is easy to interact with other foods and drugs and lead to unstable blood concentration, so in the process of use to achieve a regular diet, not partial food, so as to minimize the impact of diet.
3, regular review and monitoring of relevant indicators: warfarin use process needs to be more closely monitored prothrombin time international normalized ratio (INR), so that it is maintained between 2 ~ 3, the frequency of inspection is about 1-2 weeks, so as to be able to more accurately adjust its medication; in addition, the effect of various anticoagulation therapy also needs to be regularly evaluated, such as pulmonary ventilation / perfusion scan, CT pulmonary angiography, cardiac ultrasound, venous ultrasound of both lower limbs, D-dimer, etc.
4. Pay attention to self-observation: you should observe some symptom changes related to pulmonary embolism, such as chest tightness, chest pain, hemoptysis, lower limb edema, etc. The fact that these symptoms do not relieve, or worsen, or worsen again after improvement is a signal that you need to seek medical attention again.
Secondly, how to be alert to excessive anticoagulation?
1, medication as prescribed by the doctor, regular monitoring, and regular diet are also basic safeguards to prevent excessive anticoagulation
If there is bleeding in the abdominal cavity, it is mostly manifested as pale face, abdominal pain, abdominal distension and blue spots on the abdominal wall, etc. Gastrointestinal bleeding is mostly manifested as pale face, nausea, abdominal pain and black stool.
The occurrence of pulmonary embolism is closely related to daily life, and we can only enhance the vigilance of this disease.
The only way to reduce the occurrence of pulmonary embolism from the source is to avoid its predilection factors or to prevent them as much as possible; its long treatment course also requires close monitoring and observation during its long-term treatment in order to achieve adequate anticoagulation efficacy and reduce the occurrence of complications. Pulmonary embolism is a common life-threatening disease, and we can only effectively and safely end this “silent killer” by taking both “prevention” and “treatment” measures and dealing with it calmly.