Jobst Vascular Institute, Toledo, Ohio 43606, USA.
J Vasc Surg. 2012 Feb;55(2):607-11. doi: 10.1016/j.jvs.2011.06.005. Epub 2011 Jul 29.
The key questions addressed in this summary are whether clot removal should be part of the preferred therapy for patients with acute deep venous thrombosis (DVT), and whether there is evidence that a strategy of thrombus removal offers better outcomes for patients than anticoagulation alone. Evidence is defined as an outward sign or something that furnishes proof. Evidence in medicine is not limited to direct, blinded comparisons of one form of treatment compared with another but rather the body of knowledge that provides insight to clinicians to offer patient care. Evidence-based medicine follows from information available to form the foundation for the use of a treatment for a specific disease. Reports of strategies of thrombus removal for acute DVT, especially in patients with iliofemoral DVT, consistently demonstrate improved outcomes relative to postthrombotic morbidity. This summary reviews the evidence supporting this strategy as the preferred initial management of patients with extensive proximal DVT.
对于急性深静脉血栓形成（DVT）患者，是否应将血栓清除作为首选治疗方法的一部分；与单独抗凝治疗相比，血栓清除策略是否能为患者带来更好的结果。证据是指外在的迹象或提供证明的东西。医学中的证据不仅限于一种治疗方法与另一种治疗方法的直接、盲目的比较，而是为临床医生提供洞察力以提供患者护理的知识体系。循证医学是根据现有信息形成特定疾病治疗方法使用基础的。急性 DVT 尤其是髂股静脉 DVT 的血栓清除策略的报告显示，与血栓后发病率相比，其结果得到了改善。本综述回顾了支持这一策略的证据，该策略是广泛近端 DVT 患者首选的初始治疗方法。
