Bauersachs R, Haas S, Schellong S
Medizinische Klinik IV, Max-Ratschow-Klinik für Angiologie, Klinikum Darmstadt, Heidelberger Landstrasse 379, 64297 Darmstadt.
Hamostaseologie. 2004 Aug;24(3):167-72. doi: 10.1267/hamo04030167.
There is sound evidence, that low molecular weight heparin (LMWH) administered subcutaneously is at least as effective and safe as an i.v. infusion of unfractionated heparin. Thus, with LMWH out-patient treatment of deep vein thrombosis (DVT) becomes feasible. According to the current guidelines, an objective diagnosis of DVT is required before the anticoagulation with heparin is initiated. Close monitoring is also required during the subsequent initiation of treatment with vitamin K antagonist. Contraindications and comorbid conditions need to be identified and may necessitate hospital treatment. A checklist may assist in the decision for or against out-patient treatment, but an individual assessment for the individual patient is always a requisite.
有充分证据表明,皮下注射低分子量肝素(LMWH)至少与静脉输注普通肝素一样有效和安全。因此,使用LMWH对深静脉血栓形成(DVT)进行门诊治疗成为可能。根据当前指南,在开始使用肝素进行抗凝治疗之前,需要对DVT进行客观诊断。在随后开始使用维生素K拮抗剂治疗期间也需要密切监测。需要确定禁忌症和合并症,可能需要住院治疗。一份清单可能有助于决定是否进行门诊治疗,但对个体患者进行个体化评估始终是必要的。