静脉血栓栓塞
Faizan Khan1, Tobias Tritschler2, Susan R Kahn3
1School of Epidemiology and Public Health, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, ON, Canada.
Lancet (London, England)
|May 13, 2021
概括
静脉血栓塞栓症 (VTE) 影响着全球数以百万计的人. 诊断结合了临床评分,D-二次测试和成像,并使用直接口服抗凝剂作为主要治疗.
科学领域:
- 心脏病学
- 血液学
- 内部医学
背景情况:
- 静脉血栓塞栓症 (VTE),包括深静脉血栓和肺栓塞,是每年影响数百万人的重大全球健康问题.
- 虽然主要的手术和活跃的癌症是很强的风险因素,但许多静脉突发症是无缘的.
- 目前的诊断途径包括临床概率评估,D-二次测试和成像.
研究的目的:
- 提供静脉血栓栓塞的诊断,治疗和预防的概述.
- 突出口服抗凝剂 (DOAC) 在静脉突发症治疗中的作用.
- 讨论正在进行的VTE护理的研究方向.
主要方法:
- 连续诊断工作,包括临床评分 (例如,威尔斯评分),D-二次测试和成像 (超声波,CT,V/Q扫描).
- 大多数VTE患者 (包括癌症患者) 的第一线治疗是直接口服抗凝剂 (DOAC).
- 根据风险分层的抗凝药持续时间:因引起的事件而在3-6个月后停止治疗,因高风险或未引起的静脉动脉突发症而进行无限期治疗.
主要成果:
- 在临床概率低且D-二次数正常的患者中,可以排除VTE.
- 对于几乎所有静脉突发症患者来说,DOACs是首线治疗方案.
- 根据引起因素和复发风险与出血风险,对抗凝血的持续时间是个性化的.
结论:
- 有效诊断VTE依赖于多步骤的方法.
- 在现代静脉瘤治疗中,
- 未来的研究旨在完善诊断工具,比较抗凝剂,并个性化静脉瘤预防和管理策略.
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