de Jong Jip, Lucassen Wim A M, Geersing Geert-Jan, Burgers Jako S, Wiersma Tjerk
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Utrecht.
Ned Tijdschr Geneeskd. 2015;159:A8657.
The revised Dutch College of General Practitioners (Nederlands Huisartsen Genootschap [NHG]) guideline 'Deep-vein thrombosis and pulmonary embolus' includes recommendations for the treatment of patients with deep-vein thrombosis (DVT) and thrombophlebitis, and for the exclusion of pulmonary embolism (PE). The general practitioner (GP) can exclude the presence of DVT or PE in some patients by using a decision rule and a D-dimer test. When using D-dimer test as a point-of-care test, meticulous care is essential during the test procedure and storage of blood. The GP can treat many patients with DVT; the NHG guideline does not advise use of direct oral anticoagulants. In the case of an isolated DVT in the calf, treatment with anticoagulants or ultrasound follow-up can be chosen in consultation with the patient or on the basis of regional agreements. In the case of patients with superficial thrombophlebitis, a wait-and-see approach is usually sufficient.
荷兰全科医生学院（Nederlands Huisartsen Genootschap [NHG]）修订后的指南“深静脉血栓形成和肺栓塞”包括对深静脉血栓形成（DVT）和血栓性静脉炎患者的治疗建议，以及肺栓塞（PE）的排除建议。全科医生（GP）可以通过使用决策规则和D-二聚体检测在某些患者中排除DVT或PE的存在。当使用D-二聚体检测作为即时检测时，在检测过程和血液储存期间必须格外小心。全科医生可以治疗许多DVT患者；NHG指南不建议使用直接口服抗凝剂。对于小腿孤立性DVT，可与患者协商或根据地区协议选择抗凝治疗或超声随访。对于浅表血栓性静脉炎患者，通常采取观察等待的方法就足够了。
