Decousus Herve, Epinat Magali, Guillot Karine, Quenet Sara, Boissier Christian, Tardy Bernard
Groupe de Recherche sur la Thrombose, Université Jean Monnet, Saint-Etienne, France.
Curr Opin Pulm Med. 2003 Sep;9(5):393-7. doi: 10.1097/00063198-200309000-00009.
Superficial vein thrombosis (SVT) risk factors are close to those of venous thromboembolism (VTE). Diagnosis is made in a clinical setting but ultrasonography is useful to eliminate concomitant deep vein thrombosis (DVT). For SVT of the lower limbs, which is the main location, varicose veins represent the principal cause but underlying conditions (e.g.: autoimmune diseases, malignancy or thrombophilia) must be sought in idiopathic, migrant or recurrent SVT and in the absence of varicose veins. Concomitant DVT and pulmonary embolism can occur in approximately 15% and 5% respectively. Historical treatments consist of anti-inflammatory agents plus elastic stockings and, in case of varicose veins, thrombectomy and stripping. Other treatments (anticoagulants, vein ligation) were assessed to limit the VTE risk. A one-month prophylactic dose of low molecular weight heparin plus elastic stockings could be the appropriate strategy in most cases. Other studies are needed before definitive conclusions can be drawn.
浅静脉血栓形成(SVT)的危险因素与静脉血栓栓塞(VTE)相近。诊断在临床环境中进行,但超声检查有助于排除合并的深静脉血栓形成(DVT)。对于作为主要发病部位的下肢SVT,静脉曲张是主要病因,但在特发性、游走性或复发性SVT且无静脉曲张的情况下,必须寻找潜在病因(如自身免疫性疾病、恶性肿瘤或易栓症)。合并DVT和肺栓塞的发生率分别约为15%和5%。既往治疗包括抗炎药物加弹力袜,对于静脉曲张患者,还包括血栓切除术和剥脱术。已评估其他治疗方法(抗凝剂、静脉结扎术)以降低VTE风险。在大多数情况下,一个月的低分子量肝素预防剂量加弹力袜可能是合适的策略。在得出明确结论之前,还需要进行其他研究。