诊断和治疗静脉血栓栓塞的基础知识
1Thrombosis and Haemophilia Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK.
Journal of thrombosis and haemostasis : JTH
|February 12, 2025
概括
静脉血栓塞栓症 (VTE),包括深静脉血栓症和肺栓塞 (PE),需要仔细的诊断和管理. 本综述概述了VTE的诊断策略,风险分层和治疗选择,强调了抗凝药的共享决策.
科学领域:
- 医学诊断 医学诊断 医学诊断
- 心血管医学 心血管医学
- 血液学 血液学 血液学
背景情况:
- 静脉血栓塞栓症 (VTE),包括深静脉血栓症 (DVT) 和肺栓塞 (PE),是一种普遍的疾病,患病率和死亡率很高.
- 非特异性症状和症状需要强有力的诊断方法,整合临床概率得分和D-二次测试,以排除低风险患者的静脉瘤.
- 抗凝药是确诊的静脉瘤的主要治疗方法,对于高风险人群,可以考虑先进的再输血疗法,以减轻早期死亡率和长期并发症.
研究的目的:
- 提供对DVT和PE诊断框架的全面概述.
- 详细说明诊断为VTE的患者的风险分层策略.
- 总结目前对VTE的管理原则,包括抗凝固药物和考虑长期后果.
主要方法:
- 审查VTE的既定诊断方案,包括临床评分和生物标志物的利用.
- 对抗凝血剂,再注射疗法和长期管理策略的治疗指南的分析.
- 在治疗决策中讨论复发性VTE与出血并发症的风险益处评估.
主要成果:
- 综合诊断策略有效地识别那些可以安全地放弃用于排斥VTE的成像患者.
- 直接口服抗凝剂简化了VTE治疗,尽管传统药物仍然适用于特定的患者群体.
- 长期管理需要平衡抗凝风险与VTE复发的风险,并应对后血栓综合征和慢性血栓栓塞性肺高血压等并发症.
结论:
- 结构化的诊断和管理方法对于优化VTE的结果至关重要.
- 共同决策对于根据个体患者的风险和偏好量身定制抗凝治疗至关重要.
- 早期识别和管理VTE并发症对于改善长期生活质量和降低死亡率至关重要.
相关概念视频
01:04Venous Return
2.7K
The circulatory system plays a crucial role in ensuring the optimal functioning of the human body. One of its critical components is venous return - the process that completes the blood circulation cycle. This article will delve into the concept of venous return, how it works, and its significance to our health.
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system...
What is Venous Return?
Venous return refers to the rate at which blood flows back to the heart from the body's peripheral veins. It's an integral part of the circulatory system...
2.7K
01:28Esophageal Varices-II: Clinical Features and Management
37
Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
37
01:11Overview of Systemic Veins
416
Systemic veins are crucial blood vessels that return deoxygenated blood from various body tissues back to the heart. There are three systemic veins that return deoxygenated blood to the heart, they are as follows.
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
The coronary sinus, the heart's principal vein, resides in the coronary sulcus on the heart's posterior aspect. This broad venous channel receives nearly all venous blood from the myocardium, the heart muscle. It is fed by three primary veins: the great cardiac vein, the...
416
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
601
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
601
01:27Assessment of the Cardiovascular System III: Palpation
176
Palpation involves feeling the body to evaluate texture, size, consistency, and tenderness for assessing cardiovascular health. The following steps are organized in a head-to-toe order:
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
Jugular Venous Pressure (JVP) Measurement
Position the patient at a thirty- to forty-five-degree angle or in a semi-fowler's position. Look for the highest point of pulsation in the internal jugular vein and measure the vertical distance to the angle of Loius or sternal angle. A normal JVP is 3-4 cm above...
176
01:24Disorders of Hemostasis
686
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
686