Kröger K, Moerchel C
Klinik für Gefäßmedizin, HELIOS Klinik Krefeld, Lutherplatz 40, 47805, Krefeld, Deutschland.
, Obere Bogenstraße 10, 55120, Mainz-Mombach, Deutschland.
Chirurg. 2019 Jan;90(1):71-84. doi: 10.1007/s00104-018-0771-6.
Acute deep pelvic vein thrombosis (DVT) is usually a non-fatal disease that causes lifelong damage. In the case of clinical suspicion of DVT, D‑dimer determination and/or imaging must be performed. If a timely diagnosis is not possible, anticoagulation should be started. The focus of treatment is the safety of the patient. All studies on thrombus-eliminating procedures, such as thrombolysis, operative open thrombectomy and endovascular revascularization, did not show any advantages over pure anticoagulation and are associated with specific risks. The minimum duration of anticoagulation is 3 months. Thereafter, the decision of prolonged anticoagulation must be made individually for each patient. Compression therapy is an integral part of the treatment of acute TVT in Germany, even the evidence for its effectivenes with respect to the prevention of post-thrombotic syndrome is low.
急性深部盆腔静脉血栓形成（DVT）通常是一种非致命性疾病，但会造成终身损害。临床怀疑有DVT时，必须进行D-二聚体测定和/或影像学检查。若无法及时诊断，则应开始抗凝治疗。治疗的重点是患者的安全。所有关于血栓清除程序的研究，如溶栓、手术切开取栓和血管内血运重建，与单纯抗凝相比均未显示出任何优势，且伴有特定风险。抗凝的最短持续时间为3个月。此后，必须针对每位患者单独做出延长抗凝治疗的决定。在德国，压迫治疗是急性TVT治疗不可或缺的一部分，即便其预防血栓形成后综合征有效性的证据不足。
