Etiology]
1.Who is prone to deep vein thrombosis?
2.Why does deep vein thrombosis occur after childbirth?
3.Why does deep vein thrombosis occur in surgical patients?
4.Why are tumor patients prone to deep vein thrombosis?
5.Why should we do tumor screening?
6.Why do we need to do rheumatic immune screening?
7.Why can’t we find out the cause after doing many tests in hospital?
8.Should the patient complain to the doctor when deep vein thrombosis occurs in hospitalized patients?
9.Can deep vein thrombosis be predicted?
10.Is phlebitis (superficial vein thrombosis) in hospitalized intravenous infusion the responsibility of doctors and nurses?
1.Which patients are prone to develop DVT?
A: There are many causes of deep vein thrombosis, some of which are common. Many patients have a combination of factors that influence the occurrence of thrombosis.
(1) Malignant tumor, pregnancy and postpartum – hypercoagulable state of blood.
(2) Prolonged bed rest, long distance travel – slow blood flow.
(3) Trauma, surgical factors – anesthesia and bed rest (slow blood flow), tissue destruction (release of active substances, chemical damage to endothelial cells in non-surgical areas), coagulation disorders.
(4) Advanced age, oral contraceptives, blood disorders.
(5) Various other genetic and congenital factors.
2Why does deep vein thrombosis occur after childbirth?
A: Pregnancy and childbirth is a natural process, and pregnant women will face such a process as bleeding/stopping bleeding. Some women have elevated levels of hemostatic substances (e.g. fibrinogen), which can lead to thrombosis. In addition, compression of the deep veins in the abdominal cavity by the enlarged uterus affects the venous return to the lower extremities, and reduced activity leads to venous stasis in the lower extremities, etc., all of which contribute to the susceptibility of pregnant women to deep vein thrombosis.
3.Why does deep vein thrombosis occur in patients after surgery?
A: Patients are prone to deep vein thrombosis after surgery, mainly for the following reasons.
(1) Anesthesia relaxes the patient’s muscles and slows down the venous return, which easily leads to thrombosis.
(2) Surgery is treated by traumatic method, cutting skin, muscle and other kinds of tissues to destroy cells, which will release or produce various bioactive factors, these factors can damage vascular endothelial cells, with a series of complex thrombosis/anti-thrombosis process, some patients will produce deep thrombosis, these thrombosis even produce in the site far from the surgery site.
(3) The reduced activity of the patient after surgery reduces venous return, and venous stasis can easily lead to venous thrombosis.
(4) Some surgical procedures require the use of necessary hemostatic drugs, which is only a secondary factor in the development of DVT.
4.Why are tumor patients prone to deep vein thrombosis?
A: Malignant tumor patients are prone to hypercoagulable blood, in addition to surgical stimulation, chemotherapy and other toxic damage, long-term bed rest, reduced activity, etc. These factors make malignant tumor patients prone to deep vein thrombosis.
5.Why should tumor screening be done for patients with deep vein thrombosis?
Answer.
Malignant tumor patients are prone to deep vein thrombosis, and likewise, malignant tumors are often screened in reverse in deep vein thrombosis. Some patients even have deep vein thrombosis as the first symptom of malignancy.
There is no perfect solution for screening for tumors, and many tests have some false results. Screening is an effort to detect tumors as early as possible under existing conditions.
Common methods are: initial medical history and physical examination, checking blood for tumor markers, necessary imaging tests (ultrasound, X-ray, CT, etc.). It is better to get systematic consultation from oncologist.
6.Why should we do rheumatic immune screening?
A: Some immune diseases can damage blood vessels and change blood composition, which is a risk factor for deep vein thrombosis. Doing rheumatic immune screening is good for early detection of these diseases, early treatment, and delaying the occurrence of internal organ damage such as heart and kidney as much as possible.
7.Why can’t I find out the cause after being hospitalized for many tests?
A: The causes of deep vein thrombosis are very complicated, and not all the causes can be found in the clinic yet. Generally, doctors will do examinations related to tumor, rheumatism and immunity, congenital coagulation abnormalities, etc. according to the clinical performance. According to the specific situation, sometimes sets of examination, sometimes step-by-step examination.
8.Should the patient complain to the doctor when deep vein thrombosis occurs in hospitalized patients?
A: Some patients who have DVT during hospitalization will treat their supervising doctors with suspicion. In fact, the occurrence of DVT is unpredictable, and there is no official set of recognized and authoritative guidelines for clinicians to prevent DVT in hospitalized patients in China. Moreover, even with some precautions, there is no way to predict whether a patient will necessarily not develop DVT, when it will occur, which organ it will occur in, and how severe it will be, etc.
Disease is a personal event that no one wants to have happen to them. However, there is no public institution in the world that can guarantee in an institutionalized way that the patient will not have such an event.
9. Can deep vein thrombosis be predicted?
A: Deep vein thrombosis cannot be predicted. In patients with high risk of thrombosis, it can be considered whether DVT occurs with the prompting of clinical manifestations to help the physician to do further relevant examinations, which can help to detect part of DVT early.
10.Is it the responsibility of doctors and nurses to have phlebitis (superficial vein thrombosis) after inpatient intravenous infusion?
A: Any drug is a chemical substance, and many drugs are irritating; various punctures, indwelling catheters, and other measures are irritating to the veins used for infusion, so it is understandable that phlebitis (including thrombophlebitis) occurs as a result. No hospital in the world can guarantee that a patient receiving an infusion will not develop phlebitis, nor can it be predicted. Phlebitis should be considered a “medical malpractice” rather than a “physician-nurse malpractice”.
Clinical encounters with patients who have doubts and dissatisfaction sometimes require adequate explanation to eliminate this “imaginary, non-existent medical malpractice” caused by a distrustful social environment.