Kahn Susan R, Ginsberg Jeffrey S
Department of Medicine, McGill University, Center for Clinical Epidemiology & Community Studies, Sir Mortimer B. Davis Jewish General Hospital, Montreal, Quebec, Canada.
Arch Intern Med. 2004 Jan 12;164(1):17-26. doi: 10.1001/archinte.164.1.17.
The postthrombotic syndrome (PTS) is a frequent complication of deep venous thrombosis (DVT). Clinically, PTS is characterized by chronic, persistent pain, swelling, and other signs in the affected limb. Rarely, ulcers may develop. Because of its prevalence, severity, and chronicity, PTS is burdensome and costly. Preventing DVT with the use of effective thromboprophylaxis in high-risk patients and settings and minimizing the risk of ipsilateral DVT recurrence are likely to reduce the risk of development of PTS. Daily use of compression stockings after DVT might reduce the incidence and severity of PTS, but consistent and convincing data about their effectiveness are not available. Future research should focus on standardizing diagnostic criteria for PTS, identifying patients at high risk for PTS, and rigorously evaluating the role of thrombolysis in preventing PTS and of compression stockings in preventing and treating PTS. In addition, novel therapies should be sought and evaluated.
血栓形成后综合征(PTS)是深静脉血栓形成(DVT)的常见并发症。临床上,PTS的特征是患肢出现慢性、持续性疼痛、肿胀及其他体征。溃疡很少见。由于其普遍性、严重性和慢性,PTS带来沉重负担且费用高昂。在高危患者和环境中使用有效的血栓预防措施预防DVT并将同侧DVT复发风险降至最低,可能会降低PTS的发生风险。DVT后每日使用压力袜可能会降低PTS的发生率和严重程度,但关于其有效性的一致且有说服力的数据尚不明确。未来的研究应专注于标准化PTS的诊断标准,识别PTS高危患者,并严格评估溶栓在预防PTS中的作用以及压力袜在预防和治疗PTS中的作用。此外,应寻找并评估新的治疗方法。