Deitelzweig S
Section Head, Hospital-Based Internal Medicine, Ochsner Clinic and Alton Ochsner Medical Foundation, New Orleans, LA.
Ochsner J. 2000 Apr;2(2):92-101.
Venous thromboembolism (VTE) accounts for a significant amount of morbidity and mortality in the United States. The diagnostic and therapeutic management has never been so varied with the numerous options now available.My purpose is to briefly review epidemiology, pathogenesis, prophylaxis, diagnosis, and treatment of VTE, highlighting the important studies and consensus recommendations informing current clinical practice. Invasive, noninvasive, direct, and indirect diagnostic modalities are reviewed with an evidence-based theme.Certainly, all patients should undergo a rigorous prophylaxis risk assessment for which various pharmacologic and nonpharmacologic options are available with varied clinical efficacy and safety profiles.Unfractioned heparins, low molecular weight heparins (LMWH), and thrombolytic agents play different roles as we enter the next millennium. Optimal outcomes with high patient satisfaction can be achieved with appropriate use of LMWHs for both deep vein thrombosis and pulmonary emboli.
在美国，静脉血栓栓塞症（VTE）导致了大量的发病和死亡。随着现在有众多选择，其诊断和治疗管理从未如此多样。我的目的是简要回顾VTE的流行病学、发病机制、预防、诊断和治疗，突出为当前临床实践提供依据的重要研究和共识性建议。以循证为主题对侵入性、非侵入性、直接和间接诊断方式进行了综述。当然，所有患者都应接受严格的预防风险评估，针对此有各种具有不同临床疗效和安全性的药物和非药物选择。在进入新千年之际，普通肝素、低分子量肝素（LMWH）和溶栓剂发挥着不同作用。通过合理使用LMWH治疗深静脉血栓形成和肺栓塞，可实现高患者满意度的最佳结果。
