Sakurai T, Maki A, Nishikimi N, Ikezawa T, Yano T, Takamatsu J, Kagami K
First Department of Surgery, Nagoya University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1992 Sep;93(9):1055-8.
Of 67 patients with acute deep vein thrombosis of the lower extremity (DVT), 43 patients were treated by venous thrombectomy and 24 patients were managed by conservative treatment. The clinical effect of thrombectomy was evaluated by analyzing follow-up results in the 2 groups. The cumulative incidences of pigmentation and stasis ulcer at the 5th year were 2.7% and 0% respectively in the thrombectomy group, and 24.3% and 10% respectively in the conservative treatment group. Pigmentation and stasis ulcer were significantly more frequent in the conservative treatment group (p < 0.01). It is concluded that venous thrombectomy is superior to conservative treatment to prevent late postthrombotic sequelae. Protein C, protein S and plasminogen were assayed in 40 DVT patients to determine the incidence of hypercoagulable state in DVT. Congenital deficiency or abnormality were found in 15 patients (37.5%). In such DVT patients with thrombophilia anticoagulant prophylaxis should be continued to decrease a risk of rethrombosis.
在67例急性下肢深静脉血栓形成(DVT)患者中,43例接受了静脉血栓切除术,24例接受了保守治疗。通过分析两组的随访结果来评估血栓切除术的临床效果。血栓切除术组第5年色素沉着和淤滞性溃疡的累积发生率分别为2.7%和0%,保守治疗组分别为24.3%和10%。保守治疗组色素沉着和淤滞性溃疡的发生率明显更高(p<0.01)。结论是静脉血栓切除术在预防血栓形成后晚期后遗症方面优于保守治疗。对40例DVT患者检测蛋白C、蛋白S和纤溶酶原,以确定DVT患者高凝状态的发生率。15例(37.5%)患者发现先天性缺乏或异常。对于此类有血栓形成倾向的DVT患者,应继续进行抗凝预防以降低再次血栓形成的风险。