Leg blood clots are a common symptom in the elderly. This is also called deep vein thrombosis of the lower limbs. It is a particularly harmful disease that often leads to blockage of the lumen and venous reflux obstruction. It often causes pain, increased local skin temperature, or leg swelling, etc. On the one hand, it is necessary to strengthen good conditioning, and on the other hand, timely treatment is required. Thrombolytic therapy is a better non-surgical treatment method. For more serious cases, surgery can be considered for treatment. What to do if the elderly have blood clots in their legs 1. Non-surgical treatment (I) Patients in the acute phase of lower limb deep vein thrombosis should stay in bed for 4 weeks with the affected limb elevated 30°. In the non-acute phase, they can engage in light physical activities indoors. (ii) Absolute bed rest: All activities should be carried out in bed, and coughing, deep breathing, violent turning over, etc. should be avoided. These behaviors can cause lower limb venous thrombi to dislodge, thereby increasing the chance of pulmonary embolism. (iii) Raise the affected limb: This is to increase venous return. Use an limb raising frame and be guided by a professional nurse. 2. Anticoagulant and thrombolytic therapy: After the application of heparin abroad, the anticoagulant therapy is changed to oral anticoagulants for 3 to 6 months, which has been established as the standard treatment for DVT. The intravenous infusion of heparin is generally for 5 days, which can reduce the recurrence rate of DVT. Note that the heparin infusion rate should not be too fast. Before using the medicine, find out whether the patient has bleeding diseases. During the anticoagulant and thrombolytic period, closely observe the patient's puncture site, nasal cavity, etc. for bleeding, black stools, coffee-like or bloody vomitus, confusion, hemiplegia, aphasia, etc., and pay close attention to the coagulation mechanism. Xue Lian et al. believe that during treatment, the prothrombin time should be maintained at 3 to 4 times the normal level. If it exceeds 7 times, there is a risk of bleeding. After thrombolysis, the patient should not get out of bed too early, and the affected limb should not be too cold or too hot, so as to avoid the detachment of partially dissolved thrombus and cause pulmonary embolism. Medical Education Network collected and sorted 3. Treatment of bleeding Bleeding is the most common complication of lower limbs, among which intracranial hematoma and subdural hematoma are the most serious bleeding complications. Ward rounds should be strengthened in nursing. Under the guidance of a doctor, the drug dosage and drip rate should be adjusted according to the condition of the patient. All nursing operations should be gentle to prevent mechanical injuries. If the gums bleed, you can rinse your mouth with cold water. If the nose bleeds, you can press the root of the nose with your thumb and index finger to stop the bleeding, or apply local cold compress or pack the nasal cavity with 0.1% epinephrine hydrochloride cotton ball. For bleeding at the puncture point, apply pressure about 1 cm above the puncture point to stop the bleeding. When the amount of bleeding is large, add 1 to 2 pieces of gelatin sponges to the puncture point for pressure bandage after pressure stops the bleeding, and add pressure with a sandbag. For bleeding in other parts of the body, anticoagulant therapy should be stopped and protamine or vitamin K1 should be given. If necessary, fresh plasma or prothrombin concentrate should be given. Anticoagulant therapy can be restarted after the blood pressure value is restored. The main reason may be the poor control of the dosage of anticoagulant and thrombolytic drugs and the individual differences in the body's tolerance to drugs. |
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