上肢深静脉血栓症:一个密集医生的观点
1Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi 110017, India.
World journal of critical care medicine
|July 3, 2023
概括
上肢深静脉血栓症 (UEDVT) 越来越多地在ICU患者中被诊断为癌症和设备使用. 诊断需要高度怀疑,抗凝剂通常是足够的治疗.
科学领域:
- 血管医学 血管医学
- 关键护理医学 关键护理医学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 上肢深静脉血栓瘤 (UEDVT) 较下肢深静脉血栓瘤少见,但具有显著的发病和死亡风险,特别是在重症监护室 (ICU) 患者中.
- 增加的发病率与癌症率的上升,预期寿命的延长以及血管内导管和器件的广泛使用有关.
- UEDVT与严重的并发症有关,包括肺栓塞,血栓后综合征和复发性血栓形成.
研究的目的:
- 重症患者上肢深静脉血栓瘤 (UEDVT) 的诊断挑战和管理策略的审查.
- 突出临床怀疑在诊断UEDVT时的重要性,当传统标记可能效率较低时.
主要方法:
- 审查关于UEDVT诊断和管理在ICU设置的当前文献.
- 讨论包括多普勒超声波,CT静脉学和MRI静脉学在内的诊断方式.
- 对治疗选择的分析,重点是抗凝治疗和血栓溶解或手术的指示.
主要成果:
- 临床预测得分和D-二次测试在诊断UEDVT时可能具有有限的效用,需要高临床怀疑指数.
- 多普勒超声波是主要的诊断工具,CT和MRI静脉图用于复杂的病例或差异.
- 抗凝固药物治疗是大多数UEDVT病例治疗的支柱;血栓溶解和手术减压很少适用.
结论:
- 由于潜在的严重并发症,对ICU患者的UEDVT及时诊断至关重要.
- 管理主要涉及抗凝药,与干预措施,如血栓溶解或手术预留给特定的,罕见的情况.
- 患者的结局受到与UEDVT相关的潜在病因和并发症的显著影响.
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