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[上肢深静脉血栓形成:病因、诊断与治疗]

[Deep venous thrombosis of the arm: etiology, diagnosis and treatment].

作者信息

Leebeek F W, Kappers-Klunne M C, Gómez-García E B

机构信息

Afd. Hematologie, Academisch Ziekenhuis Rotterdam-Dijkzigt.

出版信息

Ned Tijdschr Geneeskd. 2000 Feb 19;144(8):361-4.

Abstract

Thrombosis of the upper extremity is frequently (30-52%) related to the use of an indwelling venous catheter, but it can also occur in healthy individuals after exercise. In the past it was considered a relatively benign thrombotic event, which was treated conservatively, sometimes even without anticoagulant therapy. Recent studies have shown that complications of deep venous thrombosis of the upper extremity occur frequently: pulmonary embolism (8-36%), recurrence thrombosis after cessation of anticoagulant treatment (2-15%) and post-thrombotic syndrome (up to 50%). Therefore when thrombosis of the upper extremity is clinically suspected, it should be objectively diagnosed by compression echography followed if negative by phlebography, with anticoagulant treatment directly afterward, preferably with low-molecular heparin and then acenocoumarol or phenprocoumon.

摘要

上肢血栓形成常(30 - 52%)与留置静脉导管的使用有关,但也可在健康个体运动后发生。过去它被认为是一种相对良性的血栓形成事件,采用保守治疗,有时甚至不进行抗凝治疗。最近的研究表明,上肢深静脉血栓形成的并发症频繁发生:肺栓塞(8 - 36%)、抗凝治疗停止后复发性血栓形成(2 - 15%)和血栓形成后综合征(高达50%)。因此,当临床上怀疑上肢血栓形成时,应通过压迫超声检查进行客观诊断,若结果为阴性则进行静脉造影,随后直接进行抗凝治疗,最好使用低分子肝素,然后使用醋硝香豆素或苯丙香豆素。

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