Sato S, Iwai T, Sakurazawa K, Inoue Y, Takiguchi N, Sugano N, Endo M
First Department of Surgery, Tokyo Medical and Dental University, Japan.
Nihon Geka Gakkai Zasshi. 1992 Sep;93(9):1052-4.
To evaluate conservative treatment for acute deep vein thrombosis (DVT) of lower extremities, 56 limbs of 53 patients (29 men and 24 women, age ranging 20 to 77 years, mean age of 50.1 years) were reviewed. Only three patients underwent thrombectomy of restricted iliac venous regions by Fogarty catheter within 24 hours of the onset and their symptoms were relieved immediately after operation with good follow-up condition. Forty-five limbs were treated conservatively. Among 45 limbs, 15 limbs were treated within 7 days of symptom's onset using heparin and urokinase for 6-10 days followed by oral anticoagulant. Forty-seven percent of the patients were freed from their symptoms within one year. However 30 limbs received conservative therapy after 7 days of the onset showed 23% recovery from their symptoms within one year and in extensive thrombosis recovery was only 14%. We concluded that conservative treatment for DVT was effective if it was started within 7 days of the onset, and thrombectomy of ilio-femoral regions might be more effective than conservative treatment under the same condition.
为评估下肢急性深静脉血栓形成(DVT)的保守治疗效果,我们回顾了53例患者的56条肢体(29例男性和24例女性,年龄在20至77岁之间,平均年龄50.1岁)。仅3例患者在发病后24小时内通过Fogarty导管对受限的髂静脉区域进行了血栓切除术,术后症状立即缓解,随访情况良好。45条肢体接受了保守治疗。在这45条肢体中,15条肢体在症状出现后7天内接受治疗,使用肝素和尿激酶治疗6 - 10天,随后口服抗凝剂。47%的患者在一年内症状消失。然而,30条肢体在发病7天后接受保守治疗,其中23%的患者在一年内症状有所缓解,在广泛血栓形成的病例中,恢复率仅为14%。我们得出结论,DVT在发病7天内开始进行保守治疗是有效的,在相同情况下,髂股区域的血栓切除术可能比保守治疗更有效。