深静脉血栓形成的原因是深静脉血栓
Paul A Kyrle1, Sabine Eichinger
1Medical University of Vienna, Department of Internal Medicine I, Währinger Gürtel 18-20, 1090 Vienna, Austria. paul.kyrle@meduniwien.ac.at
Lancet (London, England)
|March 30, 2005
概括
深静脉血栓 (DVT) 和肺栓塞是常见的. 使用抗凝血和诊断工具的预防,如D-二聚体测试,有助于管理和预防这些严重的疾病.
科学领域:
- 心血管医学 心血管医学
- 血液学 血液学 血液学
- 血管外科 血管外科
背景情况:
- 深静脉血栓 (DVT) 和其并发症,肺栓塞 (PE) 和血栓后综合征 (PTS) 是普遍存在的医学疾病.
- 血栓形成可以是自发的,也可以是手术,创伤或不运动引起的,需要采取预防措施.
- 有效的预防包括低剂量抗凝药,特别是在高危人群中.
研究的目的:
- 审查目前对深静脉血栓塞 (DVT) 和其后果的理解.
- 讨论诊断策略,包括成像和血清学标记.
- 概述治疗方法,包括抗凝血和风险因素修改.
主要方法:
- 关于深静脉血栓症 (DVT),肺栓塞 (PE) 和血栓后综合征 (PTS) 的现有文献的综述.
- 分析诊断模式,如超声波,静脉和D-二次体检测.
- 对预防性和治疗性抗凝策略的评估,包括低分子量肝素 (LMWH) 和维生素K对抗剂 (VKAs).
主要成果:
- 临床风险评估和D-二次体测量对于排除DVT至关重要,因为只有25%的症状患者有确定的血栓.
- 低分子量肝素 (LMWH),其次是维生素K抗体 (VKAs),有效地防止了血栓的进展和栓塞.
- 抗凝治疗的持续时间各不相同;对于许多人来说,3-6个月就足够了,而无限期治疗对特定的患者群体有益 (例如,抗血缺乏症,狼抗凝剂,同卵性缺陷,复发性DVT).
- 在癌症患者中,LMWH显示出比VKA更高的疗效和可比的安全性.
- 虽然女性的风险通常较低,但怀孕和激素治疗 (口服避孕药,HRT) 显著增加了血栓形成的风险.
结论:
- 深静脉血栓症 (DVT) 的管理需要一个多方面的方法,结合风险评估,准确的诊断和适当的抗凝药.
- 个性化治疗持续时间和药物选择 (LMWH与VKA) 是至关重要的,特别是在癌症患者等特定人群中.
- 对风险因素的认识,包括荷尔蒙影响和遗传倾向,对于预防和管理至关重要.
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