Sultanov D D, Gaibov A D, Toirov M G
Angiol Sosud Khir. 2013;19(2):11-6.
The authors analysed the findings of examination and treatment of 61 patients presenting with acute thrombophlebitis of lower-limb deep veins, also investigating the risk factors for the development of acute thrombophlebitis. Of these, 54 (88.5%) patients were found to have various risk factors. During treatment we studied efficacy of anticoagulant therapy, also carried out examination of the blood coagulogram. Depending on the method of anticoagulant therapy, all patients were subdivided into two groups: Group One patients (n=30) received a combination of heparin and warfarin and Group Two patients were given monotherapy with heparin alone. It was determined that combined administration of two anticoagulants resulted in prolongation of the value of the activated partial thromboplastin time by 20% from the normal one in the majority of those receiving it (n=22, 73.3%), whereas in Group Two patients it was observed only in 12 (38.7%) patients. The values of the international normalized ratio in Group One patients were within the therapeutic (2.0-3.0) range, while in Group Two patients they were less than 2.0. There were neither haemorrhagic nor thrombolytic complications associated with administration of anticoagulants in either group. A combination of two anticoagulants turned out to be more effective for reaching adequate and safe hypocoagulation. The authors also worked out a therapeutic regimen and policy of follow up of patients presenting with acute thrombophlebitis. The comprehensive set of treatment included an effective route of paransal administration of the therapeutic mixture, favourably influencing the course and regress of the inflammatory process. The immediate results were as follows: good and satisfactory outcomes amounted to 93.4%, and poor results were noted in 6.6%. The short-term results were studied for up to 6 months revealing that 83% of patients had evidence of recanalization of the thrombosed veins, and only 17% demonstrated chronic occlusion.
作者分析了61例下肢深静脉急性血栓性静脉炎患者的检查和治疗结果,并研究了急性血栓性静脉炎发生的危险因素。其中,54例(88.5%)患者被发现有各种危险因素。治疗期间,我们研究了抗凝治疗的疗效,还进行了凝血图检查。根据抗凝治疗方法,所有患者被分为两组:第一组患者(n = 30)接受肝素和华法林联合治疗,第二组患者仅接受肝素单一疗法。结果发现,联合使用两种抗凝剂使大多数接受该治疗的患者(n = 22,73.3%)的活化部分凝血活酶时间值比正常延长20%,而在第二组患者中,仅12例(38.7%)出现这种情况。第一组患者的国际标准化比值在治疗范围(2.0 - 3.0)内,而第二组患者的值小于2.0。两组在使用抗凝剂过程中均未出现出血或溶栓并发症。联合使用两种抗凝剂在达到充分且安全的低凝状态方面更有效。作者还制定了急性血栓性静脉炎患者的治疗方案和随访策略。综合治疗方案包括经鼻给药治疗混合物的有效途径,这对炎症过程的进展和消退有有利影响。近期结果如下:良好和满意的结果占93.4%,不良结果占6.6%。对短期结果进行了长达6个月的研究,结果显示83%的患者有血栓形成静脉再通的证据,只有17%表现为慢性闭塞。