Scerrati Alba, Menegatti Erica, Zamboni Matilde, Malagoni Anna Maria, Tessari Mirko, Galeotti Roberto, Zamboni Paolo
Unit of Neurosurgery, University Hospital of Ferrara, 44121 Ferrara, Italy.
Vascular Diseases Center, University Hospital of Ferrara, 44121 Ferrara, Italy.
Diagnostics (Basel). 2021 Feb 23;11(2):378. doi: 10.3390/diagnostics11020378.
(1) Background: internal jugular vein thrombosis (IJVthr) is a potentially life-threating disease but no comprehensive reviews on etiology, symptomatology, diagnosis and current treatment guidelines are yet available; (2) Methods: we prospectively developed a protocol that defined objectives, search strategy for study identification, criteria for study selection, data extraction, study outcomes, and statistical methodology, according to the PRISMA standard. We performed a computerized search of English-language publications listed in the various electronic databases. We also retrieved relevant reports from other sources, especially by the means of hand search in the Glauco Bassi Library of the University of Ferrara; (3) Results: using the predefined search strategy, we retrieved and screened 1490 titles. Data from randomized control trials were few and limited to the central vein catheterization and to the IJVthr anticoagulation treatment. Systematic reviews were found just for Lemierre syndrome, the risk of pulmonary embolism, and the IJVthr following catheterization. The majority of the information required in our pre-defined objectives comes from perspectives observational studies and case reports. The methodological quality of the included studies was from moderate to good. After title and abstract evaluation, 1251 papers were excluded, leaving 239 manuscripts available. Finally, just 123 studies were eligible for inclusion. We found out the description of 30 different signs, symptoms, and blood biomarkers related to this condition, as well as 24 different reported causes of IJVthr. (4) Conclusions: IJVthr is often an underestimated clinical problem despite being one of the major sources of pulmonary embolism as well as a potential cause of stroke in the case of the upward propagation of the thrombus. More common symptoms are neck pain and headache, whereas swelling, erythema and the palpable cord sign beneath the sternocleidomastoid muscle, frequently associated with fever, are the most reported clinical signs. An ultrasound of the neck, even limited to the simple and rapid assessment of the compression maneuver, is a quick, economic, cost-effective, noninvasive tool. High quality studies are currently lacking.
(1) 背景：颈内静脉血栓形成（IJVthr）是一种潜在的危及生命的疾病，但目前尚无关于其病因、症状学、诊断及当前治疗指南的全面综述；(2) 方法：我们根据PRISMA标准前瞻性地制定了一项方案，该方案明确了目标、用于研究识别的检索策略、研究选择标准、数据提取、研究结果及统计方法。我们对各种电子数据库中列出的英文出版物进行了计算机检索。我们还从其他来源检索了相关报告，特别是通过在费拉拉大学的Glauco Bassi图书馆进行手工检索的方式；(3) 结果：使用预定义的检索策略，我们检索并筛选了1490个标题。来自随机对照试验的数据很少，且仅限于中心静脉置管和IJVthr抗凝治疗。仅发现了关于勒米尔综合征、肺栓塞风险及置管后IJVthr的系统评价。我们预定义目标中所需的大部分信息来自观察性研究和病例报告的视角。纳入研究的方法学质量从中等到良好。经过标题和摘要评估，排除了1251篇论文，剩下239篇手稿。最后，仅有123项研究符合纳入标准。我们找出了与该病症相关的30种不同体征、症状和血液生物标志物的描述，以及24种不同的IJVthr报告病因。(4) 结论：尽管IJVthr是肺栓塞的主要来源之一，并且在血栓向上蔓延的情况下是中风的潜在原因，但它常常是一个被低估的临床问题。更常见的症状是颈部疼痛和头痛，而肿胀、红斑以及胸锁乳突肌下方可触及的索状体征，常伴有发热，是报告最多的临床体征。颈部超声，即使仅限于对压迫动作进行简单快速评估，也是一种快速、经济、性价比高的非侵入性工具。目前缺乏高质量的研究。
