1.The most important thing is to check INR value regularly (every 1 or 2 weeks), it is better to keep it between 2.0 and 2.5.
2, Pay attention to any bleeding from gums or nose, or blood in urine, if any, please check immediately and stop warfarin treatment.
3, warfarin drug has individual differences, the dosage is different for each person. Please treat each person according to their own situation and according to the guidance of a determined doctor.
4, wearing elastic stockings is an effective way to prevent sequelae. Zhang Xiewei, Department of Vascular Surgery, The First Affiliated Hospital of Nanjing Medical University
5, pay attention to the adjustment of diet.
6, pay attention to check any factors in the blood that cause blood hypercoagulation, and get rid of the hypercoagulable state in time.
7. Elevating the affected limb when sleeping at night is beneficial to the venous blood return of the limb and elimination of swelling.
8.Pay attention to patients with hypertension, hyperglycemia and hyperlipidemia should be treated promptly.
9.Drink more water, but those with renal insufficiency should consult a nephrologist.
10, only when the blood indicators are within the normal range, the issue of drug discontinuation can be considered.
Three major groups of people are prone to lower limb deep vein thrombosis
1.Elderly people
There are many reasons why the elderly are prone to lower limb deep vein thrombosis.
First, the vascular endothelial cells of the elderly produce more procoagulant substances and less antithrombotic substances.
Secondly, although the number of platelets in the elderly is not significantly different from that of middle-aged and young people, the nature of platelets has changed significantly. The increase of platelet adrenergic receptors in the elderly makes platelets more reactive to inducing agents such as adrenaline.
Third, as people age, the plasma fibrinogen content gradually increases. Generally, the plasma fibrinogen content of people aged 50 years old has increased significantly compared with those aged 20 to 30 years old, and that of people aged 70 years or older is about twice that of young people. The anticoagulation system of the elderly also changes significantly, and after the age of 40, the plasma antithrombin content gradually decreases with age.
Fourth, fibrinolytic activity is reduced in the elderly, which is associated with extensive damage to vascular endothelial cells and reduced synthesis and secretion of tissue-type fibrinogen activator in the elderly.
In addition to the above-mentioned reasons, the elderly are also prone to thrombosis because of their weak physical strength and quietness, especially in winter when outdoor activities are rare. These factors are also important reasons for the tendency of thrombosis in the elderly, as they are often associated with various age-related diseases, such as atherosclerosis and diabetes mellitus.
2.Women during pregnancy and childbirth
Lower extremity deep vein thrombosis and its secondary pulmonary embolism is one of the major diseases that endanger the safety of mother and fetus during pregnancy and puerperium. The incidence of lower extremity venous thrombosis is higher during pregnancy due to the increase of physiological blood coagulation and the change of blood flow in lower extremities, and the incidence of lower extremity venous thrombosis during pregnancy is 0.05%~0.1% according to British scholars. The high incidence of lower extremity venous thrombosis during pregnancy and delivery is due to the physiological increase in blood volume, venous vasodilatation and decreased blood flow velocity in pregnant women in late pregnancy.
In addition, the enlarged uterus compresses the iliac vein and inferior vena cava, causing stagnation of venous blood flow in the lower extremities, making the venous system of the lower extremities vulnerable to thrombosis. In addition, almost all coagulation factors increase in varying degrees from mid-pregnancy onwards, reaching a peak at the time of delivery. The latter is a physiological compensatory reaction, which is conducive to rapid and effective hemostasis after delivery, but also leads to an increased incidence of lower limb deep vein thrombosis.
3.Tumor patients
Among the patients with lower extremity deep vein thrombosis we have treated in recent years, there have been several cases of readmission for surgery shortly after discharge because of malignancy. This suggests that thrombosis may be an early symptom of malignancy and that patients with lower extremity deep vein thrombosis may have underlying tumors. Medical research has recognized that patients with malignant tumors are prone to thrombosis because many tumor cells can secrete procoagulant substances, which can initiate a coagulation “waterfall” in the patient’s body. Of course, surgery and postoperative bed rest also contribute to the vulnerability of tumor patients to lower extremity deep vein thrombosis.
Diet and thrombosis prevention
The prevention of venous thrombotic disease should start with the removal of risk factors. In addition to the pathological state, the risk factors also include life factors, factors of various pathological states, the main treatment of the original disease and attention to the prevention and interruption of the cause of thrombosis caused by the original disease.