Ro Ayako, Kageyama Norimasa, Fukunaga Tatsushige
Department of Legal Medicine, School of Medicine, Keio University, Tokyo.
Masui. 2007 Jul;56(7):801-7.
Prophylaxis of deep vein thrombosis (DVT) is a serious matter as the source of pulmonary thromboembolism (PTE) in hospitalized patients. Leg DVT is classified into three groups: iliac, femoral and calf types. Among them, calf type DVT is closely connected with PTE. Especially, soleal vein is the most frequent site of thrombi formation occurring with venous stagnation. Although most cases of soleal vein thrombosis are resolved soon without specific treatments: in around 20% of cases the thrombosis propagates to the proximal drainage vein as float thrombi e.g. from peroneal vein and posterior tibial vein to popliteal vein. Thereafter, the organization of thrombi leads to venous valve insufficiency, so-called postthrombotic syndrome. As a result, it worsens blood stagnation and induces recurrent thrombi formation. The broad prophylaxis of DVT in the soleal veins for inpatients is the most important point in the initial stage of hospitalization.
住院患者深静脉血栓形成(DVT)的预防是一个严肃的问题,因为它是肺血栓栓塞症(PTE)的来源。腿部深静脉血栓分为三组:髂静脉型、股静脉型和小腿型。其中,小腿型深静脉血栓与肺血栓栓塞症密切相关。特别是,比目鱼肌静脉是静脉血流淤滞时血栓形成最常见的部位。虽然大多数比目鱼肌静脉血栓形成的病例在未经特殊治疗的情况下会很快消散,但约20%的病例中血栓会以漂浮血栓的形式蔓延至近端引流静脉,例如从腓静脉和胫后静脉蔓延至腘静脉。此后,血栓机化会导致静脉瓣膜功能不全,即所谓的血栓形成后综合征。结果,它会加重血液淤滞并诱发复发性血栓形成。对住院患者比目鱼肌静脉深静脉血栓形成进行广泛预防是住院初期最重要的一点。