Deep-vein thrombosis
Deep-vein thrombosis
复制标题
DOI：
10.1016/s0140-6736(98)04298-6
复制
发表时间：
1999-02-06
期刊：
影响因子：
168.9
通讯作者：
Büller, HR
中科院分区：
文献类型：
--
作者：
Lensing, AWA;Prandoni, P;Büller, HR
深静脉血栓形成是几种遗传性和获得性疾病的重要并发症，但也可能自发发生，预防复发性静脉血栓形成和肺栓塞是准确诊断和充分治疗的主要原因。本研讨会只讨论有症状的深静脉血栓形成。只有大约30%的有症状的患者可以通过客观检查确诊。静脉血栓栓塞并发症发生在不到1%的未经治疗的患者中，在这些患者中，静脉血栓形成的存在基于连续超声检查或超声检查加D-二聚体或临床评分而被拒绝。初始抗凝治疗（静脉或皮下肝素）应持续至口服抗凝治疗（同时开始）使国际标准化比值升高至2.0以上并持续24小时以上。口服抗凝剂治疗的最佳持续时间尚不明确，但可能受暂时或持续风险因素的存在或复发性静脉血栓栓塞的影响。
Deep-vein thrombosis is an important complication of several inherited and acquired disorders, but may also occur spontaneously, prevention of recurrent venous thrombosis and pulmonary embolism is the main reason for accurate diagnosis and adequate treatment. This seminar discusses only symptomatic deep-vein thrombosis. The diagnosis can be confirmed by objective tests in only about 30% of patients with symptoms. Venous thromboembolic complications happen in less than 1% of untreated patients in whom the presence of venous thrombosis is rejected on the basis of serial ultrasonography or ultrasonography plus either D-dimer or clinical score. Initial anticoagulant treatment (intravenous or subcutaneous heparin) should continue until oral anticoagulant treatment, started concurrently, increases the international normalised ratio above 2.0 for more than 24 h. The optimum duration of oral anticoagulant treatment is unresolved, but may be guided by the presence of temporary or persistent risk factors or presentation with recurrent venous thromboembolism.