Huber P, Schmitt H E, Jäger K
Departement für Innere Medizin, Kantonsspital Basel.
Schweiz Med Wochenschr. 1988 Sep 3;118(35):1230-6.
Deep vein thrombosis of the upper extremity is rare. While its pathogenesis is not always evident, it often occurs in connection with tumors, thoracic outlet syndrome or intravenous catheter therapy. Acute thrombosis of the subclavian vein usually is a clinical diagnosis, but in doubtful cases diagnostic tests such as Doppler ultrasound and/or plethysmography may be useful. If necessary, verification of subclavian vein thrombosis can be done by phlebography. Considering the incidence of thromboembolic complications such as pulmonary embolism, anticoagulation is indicated in all cases of acute thrombosis. Under standard conservative treatment residual symptoms following the venous occlusion are few and the prognosis is favorable. Therefore, invasive treatment such as thrombectomy or thrombolysis should be considered only in special cases.
上肢深静脉血栓形成较为罕见。虽然其发病机制并不总是很明确,但它常与肿瘤、胸廓出口综合征或静脉导管治疗相关。锁骨下静脉急性血栓形成通常靠临床诊断,但在可疑病例中,诸如多普勒超声和/或体积描记法等诊断性检查可能会有帮助。如有必要,可通过静脉造影术来证实锁骨下静脉血栓形成。鉴于肺栓塞等血栓栓塞并发症的发生率,所有急性血栓形成病例均需进行抗凝治疗。在标准保守治疗下,静脉闭塞后残留症状很少,预后良好。因此,仅在特殊情况下才应考虑诸如血栓切除术或溶栓等侵入性治疗。