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Abstract: A female patient with sudden onset of left neck swelling and pain accompanied by facial swelling for 4 days came to the clinic and was diagnosed with deep vein thrombosis after ultrasound, CT, coagulation function and other tests. The patient was given low-molecular weight heparin sodium injection and Mai Zhi Ling tablets, which have the effects of anticoagulation, promoting venous reflux and improving microcirculation. After active treatment, the patient’s thrombus was mostly ablated and the pain and swelling symptoms were significantly relieved or even disappeared.
Basic information】Female, 57 years old
Disease Type】Deep Vein Thrombosis
Hospital】Liaoning Provincial People’s Hospital
Date of consultation】April 2022
Treatment plan】Medication (low molecular weight heparin sodium injection+MaiZhiLing tablet+PoppySine Hydrochloride injection)
Treatment period】10 days of inpatient treatment, 1 month of outpatient follow-up
Effectiveness】The pain and swelling were significantly relieved and even disappeared, and the thrombus was mostly ablated.
I. Initial consultation
A 57-year-old middle-aged female patient came to our department complaining of left neck pain with no obvious cause 4 days ago, accompanied by swelling of the left neck and face, slightly relieved in upright or sitting position, and aggravated in lying down position. The patient said he had no history of hypertension, diabetes, heart disease or cerebrovascular disease. The patient was found to have stable vital signs, swelling of the left neck and back of shoulder, normal skin color, normal skin temperature, multiple enlarged lymph nodes palpable in the left supraclavicular fossa and axilla, positive local pressure pain, no swelling of the left upper limb, good skin temperature and color, palpable pulsation of the left ulnar and radial arteries, and palpable pulsation of the left brachial artery, so the preliminary diagnosis of deep vein thrombosis was made.
II. Treatment history
After admission, the patient was given relevant examinations, and the review ultrasound indicated that the left jugular vein was filled with inhomogeneous echogenic material throughout, and the CDFI did not detect the exact blood flow signal, and the left jugular vein was thrombosed. Therefore, the diagnosis of deep vein thrombosis was confirmed. The patient was then given low-molecular-weight heparin sodium injection for anticoagulation therapy, oral Mizarin tablets to promote venous reflux, and poppy bases hydrochloride injection to improve microcirculation.
III. Treatment effect
After 1 week of anticoagulation and improvement of microcirculation, the patient’s symptoms of neck and facial swelling and pain were significantly relieved, and the results of D-2 aggregation were basically normal after 10 days of treatment, suggesting that the thrombus was basically stable, so the patient was discharged from the hospital. The patient was asked to come to the outpatient clinic for review one month later. When the patient came for review, he said that he had no obvious discomfort, the swelling and pain disappeared, and the ultrasound showed that most of the thrombus was dissolved, so the treatment effect was good, and there was no bleeding or recurrence of thrombus.
IV. Notes
We are glad that the patient’s condition has been stabilized after active medication and no other uncomfortable symptoms have been delayed. However, it is recommended that patients still need to pay attention to the following matters after discharge from the hospital.
1.After discharge from the hospital, we should pay attention to whether there are other uncomfortable symptoms in the body. Some patients have deep vein thrombosis induced by the presence of tumors, blood diseases, rheumatic immune diseases, etc. Therefore, they need to pay extra attention to their own symptoms and seek medical examination in time if they have discomfort.
2. Patients should follow the doctor’s prescription for oral anticoagulants after discharge, and pay attention to whether there is bleeding tendency, such as skin bleeding, blood in urine and stool, and consult the doctor to reduce the dosage or even stop the medication.
V. Personal insight
Deep vein thrombosis is an abnormal clotting of blood in the veins, which may lead to sudden death by pulmonary embolism in the acute stage if not treated in time. Therefore, once the unilateral limb or local swelling is obvious with swelling and pain, be alert to deep vein thrombosis, and seek medical examination and treatment in time.
In the case of unexplained deep vein thrombosis, screening for the cause should be performed. If conservative treatment is carried out, anticoagulation therapy is clinically recommended for at least six months, and ultrasound is reviewed every three months.