一个患有V因子莱登突变的患者的IVC综合征
Melissa Postoll-Downs1, Kajal Patel2, John Levasseur3
1Internal Medicine, San Antonio Uniformed Services Health Education Consortium, Joint Base San Antonio Fort Sam Houston, Texas, USA melissa.a.postoll-downs.mil@health.mil.
BMJ case reports
|February 19, 2026
概括
一个巨大的血栓导致严重的腿部胀和疼痛在一个患者的V因子. 治疗包括用阿斯拉特罗班和 fondaparinux 进行血栓去除和抗凝治疗.
科学领域:
- 血管外科 血管外科
- 血液学 血液学 血液学
- 临界护理医学 临界护理医学
背景情况:
- 维因子增加了血栓形成的风险,特别是在手术后.
- 之前的出血并发症使抗凝剂管理复杂化.
- 急性深静脉血栓塞 (DVT) 可以导致严重的四肢缺血症.
研究的目的:
- 报告一个患有V因子Leiden的患者发生大规模的 iliofemoral深静脉血栓塞 (DVT) 的病例.
- 讨论抗凝血治疗的管理挑战,在一个有出血并发症病史的患者.
- 要突出成功使用内血管凝块去除和替代抗凝策略的成功使用.
主要方法:
- 一名患有V因子Leiden的患者,有DVT病史,呈现出急性阴茎上垂体DVT.
- 诊断成像包括CT静脉扫描和护理点超声波.
- 治疗涉及内血管血栓切除术,其次是用阿斯拉特罗班进行抗凝治疗,然后过渡到 fondaparinux.
主要成果:
- 扫描图像证实左侧阴茎侧静脉中存在巨大的闭塞性血栓.
- 超声波显示下腔静脉完全崩,表明严重的静脉阻塞.
- 患者成功地进行了凝块去除,并过渡到治疗性抗凝药.
结论:
- 大规模的 iliofemoral DVT 是一种威胁四肢的疾病,需要及时干预.
- 血管内凝块的去除在某些情况下可能是有效的.
- 在患有出血风险的患者中,仔细选择抗凝剂至关重要,而阿斯巴特罗班和芬达帕里努克斯等药物提供了替代品.
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