Depenbrock Patrick J
Primary Care Sports Medicine Faculty, Family Medicine Residency Clinic, Carl R. Darnall Army Medical Center, Fort Hood, TX 76544, USA.
Curr Sports Med Rep. 2011 Mar-Apr;10(2):78-83. doi: 10.1249/JSR.0b013e318214d828.
Venous thromboembolism (VTE) is a major cause of morbidity and mortality. Treatment for VTE in athletes is similar to nonathletes. Early treatment of deep venous thrombosis (DVT) with bed rest and anticoagulation has given way to anticoagulation with early mobilization. Thrombolysis, preferably catheter-directed thrombolysis (CDT), may be used in select patients with upper extremity DVT (UEDVT). Surgical procedures should be reserved for those athletes with UEDVT who fail initial therapy. Compression devices are advocated for the treatment of postthrombotic symptoms (PTS) in lower extremity DVT (LEDVT) and UEDVT. Athletes with DVT should be encouraged to start a gradual return to activities of daily living (ADL) the day they begin anticoagulation therapy. A structured return-to-training program with progressive increase in intensity can begin shortly after ADL mastery, provided the athlete is monitored carefully for recurrence of VTE. Athletes should not engage in contact or collision sports until anticoagulation therapy is complete.
静脉血栓栓塞症（VTE）是发病和死亡的主要原因。运动员VTE的治疗与非运动员相似。早期通过卧床休息和抗凝治疗深静脉血栓形成（DVT）已被早期活动加抗凝治疗所取代。溶栓治疗，最好是导管定向溶栓（CDT），可用于部分上肢DVT（UEDVT）患者。手术应仅用于初始治疗失败的UEDVT运动员。对于下肢DVT（LEDVT）和UEDVT的血栓后症状（PTS），提倡使用加压装置治疗。应鼓励患有DVT的运动员在开始抗凝治疗当天就开始逐步恢复日常生活活动（ADL）。一旦掌握ADL，可在短期内开始有结构的恢复训练计划，并逐渐增加强度，前提是对运动员进行密切监测以防VTE复发。在抗凝治疗完成之前，运动员不应参加接触性或碰撞性运动。
