Verlato F, Zucchetta P, Prandoni P, Camporese G, Marzola M C, Salmistraro G, Bui F, Martini R, Rosso F, Andreozzi G M
Unit Care of Angiology, University Hospital of Padua, Padova, Italy.
J Vasc Surg. 1999 Dec;30(6):1113-5. doi: 10.1016/s0741-5214(99)70051-0.
The rate of objectively proven pulmonary embolism in patients with thrombophlebitis of the greater saphenous vein was studied.
Consecutive ambulant patients with thrombophlebitis of the greater saphenous vein, involving the above-knee segment, underwent a complete venous echo color Doppler examination of the lower limbs, perfusion lung scanning, and chest radiography. A high probability of pulmonary embolism was defined as the presence of two or more large segmental defects, one large and two or more moderate perfusion defects, or four or more moderate perfusion defects, with no corresponding abnormality found by means of chest radiography.
Of the 21 patients included in the study, findings compatible with a high probability of pulmonary embolism were detected in seven patients (33.3%; 95% CI, 14.6 to 57. 0), although clinical symptoms of pulmonary embolism were present only in one patient. No association was found between the presence of thrombosis at the saphenofemoral junction and the risk for pulmonary embolism.
The rate of pulmonary embolism in patients with thrombophlebitis of the greater saphenous vein is unexpectedly high. This risk is similarly high in patients with thrombosis at the saphenofemoral junction and in patients without thrombosis at the saphenofemoral junction. Our results are consistent with those of other recent investigations and suggest that superficial thrombophlebitis of the thigh is not as benign a disease entity as previously described.
研究大隐静脉血栓性静脉炎患者经客观证实的肺栓塞发生率。
对连续的大隐静脉血栓性静脉炎且累及膝上段的门诊患者进行下肢静脉彩色多普勒超声检查、肺灌注扫描及胸部X线检查。肺栓塞高度可能性定义为存在两个或更多大片段缺损、一个大片段和两个或更多中片段灌注缺损，或四个或更多中片段灌注缺损，且胸部X线检查未发现相应异常。
在纳入研究的21例患者中，7例（33.3%；95%可信区间，14.6至57.0）检测到与肺栓塞高度可能性相符的结果，尽管只有1例患者有肺栓塞临床症状。在隐股交界处血栓形成与肺栓塞风险之间未发现关联。
大隐静脉血栓性静脉炎患者的肺栓塞发生率出乎意料地高。隐股交界处有血栓形成的患者和隐股交界处无血栓形成的患者，这种风险同样高。我们的结果与其他近期研究一致，提示大腿部浅静脉血栓性静脉炎并非如既往所描述的那样是一种良性疾病。
