静脉血栓栓塞:分类、危险因素、诊断和管理。

ISRN Hematology Pub Date : 2011-01-01 Epub Date: 2011-10-17 DOI:10.5402/2011/124610
Fatemeh Moheimani, Denise E Jackson
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引用次数: 91

摘要

静脉血栓栓塞(VTE)分为深静脉血栓形成(DVT)和肺栓塞(PE)。静脉血栓栓塞与高发病率相关,并给患者、医院和政府造成巨大的经济负担。获得性和遗传性危险因素都有助于静脉血栓栓塞。为诊断静脉血栓栓塞,可采用临床概率评估和d -二聚体测量等无创、低成本的诊断算法,对疑似DVT患者采用压缩超声随访,对疑似PE患者采用多探测器计算机断层血管造影随访。有药物和机械干预来管理和预防静脉血栓栓塞。药理学方法主要针对凝血级联的非特异性途径:常规抗凝剂或特异性途径:新一代抗凝剂。过量出血是药物干预的主要危险因素之一。因此,非药物或机械方法,如下腔静脉过滤器、分级压缩长袜和间歇性气动压缩装置与药物干预相结合或单独使用可能是治疗静脉血栓栓塞的好方法。
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Venous thromboembolism: classification, risk factors, diagnosis, and management.

Venous thromboembolism (VTE) is categorised as deep venous thrombosis (DVT) and pulmonary embolism (PE). VTE is associated with high morbidity and causes a huge financial burden on patients, hospitals, and governments. Both acquired and hereditary risks factors contribute to VTE. To diagnose VTE, noninvasive cost-effective diagnostic algorithms including clinical probability assessment and D-dimer measurement may be employed followup by compression ultrasonography for suspected DVT patients and multidetector computed tomography angiography for suspected PE patients. There are pharmacological and mechanical interventions to manage and prevent VTE. The pharmacological approaches mainly target pathways in coagulation cascade nonspecifically: conventional anticoagulants or specifically: new generation of anticoagulants. Excess bleeding is one of the major risk factors for pharmacological interventions. Hence, nonpharmacological or mechanical approaches such as inferior vena cava filters, graduated compression stockings, and intermittent pneumatic compression devices in combination with pharmacological interventions or alone may be a good approach to manage VTE.

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