血栓后综合征的流行病学和诊断:通过系统审查进行定性综合
Jitendra Mangwani1, Veronica Roberts2, Odei Shannak3
1Academic Team of Musculoskeletal Surgery, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, UK.
Journal of clinical medicine
|September 28, 2023
概括
这次审查确定了四个诊断标准,用于后血栓综合征 (PTS),深静脉血栓症 (DVT) 的并发症. 将这些标准应用于现有研究有助于标准化PTS发病率和严重性评估.
科学领域:
- 血管医学 血管医学
- 临床流行病学 临床流行病学
- 医学诊断 医学诊断 医学诊断
背景情况:
- 血栓后综合征 (PTS) 是下肢深静脉血栓症 (DVT) 的常见和致残的后果.
- 由于缺乏标准化诊断标准,目前报告的PTS发病率显示出显著的异质性.
- 这次审查旨在确定PTS的最终诊断标准,并完善其报告的发病率和严重程度.
研究的目的:
- 为了制定标准化的诊断标准,以诊断血栓后综合征 (PTS).
- 根据开发的标准,精确报告的PTS发病率和严重程度.
- 为了促进未来的元分析和更高层次的证据合成PTS.
主要方法:
- 在多个数据库 (Cochrane CENTRAL,MEDLINE,Embase) 和试验注册表中进行系统的文献搜索.
- 在对339份获取的摘要进行了定性分析后,包括了33篇全文论文.
- 使用修改后的科尔曼评分系统评估证据质量;数据质量综合.
主要成果:
- 为PTS诊断提出了四个关键标准:血栓形成的放射性确认,至少24个月的随访,验证的评估得分的使用,以及静脉功能不全进展的证据.
- 当应用这些标准时,报告的轻度至中度PTS发病率缩小到736%.
- 使用Villalta尺度特别将发病率范围降低到2336%,发病率和严重程度在24个月后停滞.
结论:
- 通过定性合成,为PTS开发了四种新的诊断标准.
- 这些标准为PTS诊断提供了标准化的方法,减少了报告发生率和严重程度的变化.
- 标准化将使更强大的元分析和综合证据能够改善PTS的临床管理.
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