Efficacy And Safety Of Anticoagulation Therapy For Cerebral Hemorrhage Complicated With Deep Venous Thrombosis

Objectives: To investigate the efficacy and safety of intracerebral hemorrhage(ICH)combined with anti-coagulation therapy for deep vein thrombosis in lower limb(LDVT).Methods: A total of 23 patients with cerebral hemorrhage complicated with lower extremity venous thrombosis were enrolled in the First Affiliated Hospital of Da Lian Medical University from May 2016 to May 1818.All patients met the inclusion and exclusion criteria of this study,and accurately collected the clinical symptoms and signs,blood biochemical indicators,imaging and lower extremity color Doppler examination results.The main effects were evaluated by D-dimer index,thrombus reduction and recanalization of lower extremity vascular color Doppler ultrasonography,and changes before and after treatment of Wells DVT score.Hemorrhage,platelet,coagulation(APTT,PT,TT),urinary routine,routine,gastric occult blood,skin ecchymosis,corneal redness,gingival hemorrhage,gastrointestinal bleeding,urinary tract bleeding before and after treatment Assess treatment safety.The data were analyzed using statistical software SPSS22.0,using t test,Fisher exact probability method,rank sum test statistical method,when P <0.05,the difference was statistically significant.Results: 1.Analysis of D-dimer changes in 23 patients with venous thrombosis of lower extremity before and after anticoagulation treatment showed that D-dimer was 980(460,1230)ug/L at admission and 14260(8000,when thrombus occurred).21660)ug/L,3830(2290,7130)ug/L at discharge;23 patients with lower extremity venous thrombosis had significantly higher D-dimer levels than those before admission,and the difference was statistically significant(P<0.05);D-dimer levels in 23 patients with lower extremity venous thrombosis were significantly lower than those before thrombosis,and the difference was statistically significant(P<0.05).2.The results of 23 cases of lower extremity venous color Doppler ultrasonography in patients with lower extremity venous thrombosis were analyzed.The results showed that 2 cases(8.7%)were cured after anticoagulation therapy,11 cases(47.2%)were effective,and 9 were effective.In the case of(39.1%)and ineffective(1.3%),the total effective rate was 95.6%.3.The Wells DVT scores of 23 patients with venous thrombosis of lower extremity were analyzed.The results showed that the patient scored 1(1,2)on admission and 5(5,6)on thrombus.There was a significant difference between the patients with thrombosis and the Wells DVT score at admission(P<0.05).There was a difference between the patients after anticoagulant therapy and the Wells DVT score.Statistical significance(P<0.05)4.The laboratory indexes of 23 patients with venous thrombosis of lower extremity were analyzed and compared.The results showed that the platelet before treatment was210.22±63.048 10^9/L,and 207.48±64.772 10^9/L after treatment.The pre-treatment platelet counts of 23 patients with lower extremity venous thrombosis were lower than those after treatment,but the difference was not statistically significant(P>0.05).The APTT before treatment was 24.126±4.983 S,26.100±4.991 after treatment.S;patients before treatment TT16.7(16.1,18)s,16.5(15.2,18)s after treatment;patients before PT treatment 11.9(11.7,12.3)s,12.2(11.5,13.1)s after treatment;23 cases combined There was no significant difference in postoperative clotting images(APTT,TT,PT)between patients with lower extremity venous thrombosis(P>0.05).There were 0 cases(0%)positive for urinary occult blood before treatment and 3 cases after treatment(13.0).%);0 cases(0%)were positive for occult blood before treatment,2 cases(8.7%)after treatment;2 cases(8.7%)were positive for occult blood before treatment,0 cases(0%)after treatment,these three items There were no significant differences between the two groups before and after treatment(P>0.05).5.The analysis of intracranial hematoma changes in 23 patients with venous thrombosis of lower extremity before and after anticoagulation treatment showed that the changes of intracranial hematoma before and after anticoagulation therapy in 23 patients with lower extremity venous thrombosis were analyzed.The volume of intracranial hematoma before treatment was 15.19(10.89,30.44)ml,and the volume of intracranial hematoma after treatment was 9.44(4.79,13.86)ml.The volume of intracranial hematoma in 23 patients with venous thrombosis of lower extremity was significantly higher than that before treatment.The difference between the two was statistically significant(P<0.05).6.Analysis and comparison of 23 other patients with lower extremity venous thrombosis before and after anticoagulation treatment,the results showed: 1 case(4.3%)of skin ecchymosis before treatment,0 cases of corneal redness(0%),Gingival bleeding in 0 cases(0%),urinary tract bleeding in 0 cases(0%),skin ecchymosis after treatment in 3 cases(13.0%),corneal redness in 4 cases(17.4%)1 case of gingival bleeding(4.3%),2 cases of urinary tract hemorrhage(8.7%);23 cases of venous venous thrombosis,corneal redness,gingival bleeding after treatment of lower extremity venous thrombosis There was no significant difference between the two groups,gastrointestinal bleeding and urinary tract bleeding before treatment(P<0.05).Conclusions:In the acute phase of cerebral hemorrhage combined with lower extremity venous thrombosis,anticoagulant therapy can significantly improve the formation of venous thrombosis of the lower extremity,which not only does not lead to recurrence of cerebral hemorrhage,but also does not increase the original hematoma,and does not increase the risk of bleeding in other organs.