Prevalence and Charcteristic Features of Deep Vein Thrombosis in Patients with Severe Motor and Intellectual Disabilities

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  • Ohmori Hiromitsu
    Department of Pediatrics, National Hospital Organization Yanai Medical Center
  • Kanaoka Yasushi
    Department of Surgery, Katoh City Hospital
  • Yamasaki Masami
    Department of Neurology, National Hospital Organization Yanai Medical Center
  • Takesue Hiroko
    Department of Laboratory, National Hospital Organization Yanai Medical Center
  • Sumimoto Ryo
    Department of Surgery, National Hospital Organization Yanai Medical Center

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  • 重症心身障害児（者）におけるDVTの特性からみた臨床的検討

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Abstract

<p>Sudden death associated with patients with severe motor and intellectual disabilities (SMID) have been thought to be caused in part by venous thromboembolism (VTE), but actual situation of VTE in SMID is not clear. We examined the prevalence and location of deep vein thrombosis (DVT), and the relation of the development of crural veins in 16 patients with SMID, using ultrasonography. The maximum diameter of soleal vein was 1.6±0.5 mm. In most cases, DVT was found in the femoral veins. We could not detect thrombus in the soleal veins. In the present study, the detection ratio of DVT was high in patients with SMID who had restricted mobility capability and were bedridden, and we found the veins centrally from popliteal veins in DVT in SMID, not soleal veins, as the initial sites of the DVT. In the literature, the mean diameter of soleal veins, in healthy adults is 6.7±1.8 mm, that in contrast in SMID being smaller. Underdevelopment of intramuscular veins is possibly related to the mechanism of DVT in SMID. In the current guidelines for the management of VTE, there is limited in scope of ambulatory adults and no application cases who exhibit to SMID restricted mobility of the lower extremities and are bedridden associated with cerebral palsy and developmental motor disabilities, and such patients have associated high risk of the complications of DVT. According to our present study, it is necessary to provide appropriate guidelines for DVT in SMID considering characteristic features.</p>

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