弹性压缩袜预防近端深静脉血栓患者血栓清除术后血栓后综合征。
Elastic compression stockings to prevent post-thrombotic syndrome in proximal deep venous thrombosis patients without thrombus removal.
机构信息
Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, School of Medicine; Vascular Center of Shanghai JiaoTong University, Shanghai, China.
Department of Vascular Surgery, Shanghai Ninth People's Hospital, Shanghai JiaoTong University, School of Medicine; Vascular Center of Shanghai JiaoTong University, Shanghai, China.
出版信息
J Vasc Surg Venous Lymphat Disord. 2022 Mar;10(2):293-299. doi: 10.1016/j.jvsv.2021.06.023. Epub 2021 Aug 3.
OBJECTIVE
To evaluate the effectiveness of elastic compression stockings (ECS) in prevention of post-thrombotic syndrome (PTS) in patients suffering from proximal deep venous thrombosis (DVT) who did not undergo thrombus removal procedures.
METHODS
In this randomized trial, patients with Iliofemoral venous thrombosis (IFDVT) and femoral-popliteal venous thrombosis who had not undergone thrombus removal procedures were screened at a single medical institution between December 2016 and June 2018. These patients were randomly assigned as an ECS group (wear ECS) and control group (not wear ECS). The primary end point was the incidence of PTS based on the Villalta scale at 24 months. The secondary end points included patient quality of life and symptom severity based on the VEINES-QoL/Sym questionnaire. Recurrent DVT in the same limb, compliance with ECS use, and other adverse events were also recorded. A logistic regression analysis was also performed to determine risk factors of PTS.
RESULTS
Two hundred thirty-two patients were included in this study. One hundred thirteen patients were in the ECS group and 119 in the control group. The incidence of PTS was 42.0% in the ECS group and 57.8% in the control group at 24 months (risk ratio [RR], 0.726; 95% confidence interval [CI] 0.547-0.964; P = .024). The VEINES-QoL score was 63.7 ± 4.6 in the ECS group, which was higher than in the control group (60.6 ± 6.9; P < .001). Moreover, the VEINES-Sym scores revealed that patients in the ECS group reported better symptom relief than those in the control group (45.8 ± 5.1 vs 43.8 ± 6.1; P = .014). According to Logistic regression analysis of the entire cohort, IFDVT was a risk factor for PTS (RR, 2.253; 95% CI, 1.136-4.468) and high compliance with the use of ECS was protect factor (RR, 0.516; 95% CI, 0.277-0.961).
CONCLUSIONS
These results suggest that ECS can prevent PTS in patients with IFDVT and femoral popliteal venous thrombosis who do not undergo thrombus removal procedures.
目的
评估在未接受血栓清除术的近端深静脉血栓（DVT）患者中，弹性压缩袜（ECS）对预防血栓后综合征（PTS）的效果。
方法
在这项随机试验中，于 2016 年 12 月至 2018 年 6 月在一家医疗机构筛选出未接受血栓清除术的髂股静脉血栓（IFDVT）和股腘静脉血栓患者。这些患者被随机分配到 ECS 组（穿 ECS）和对照组（不穿 ECS）。主要终点是 24 个月时根据 Villalta 量表评估的 PTS 发生率。次要终点包括 VEINES-QoL/Sym 问卷评估的患者生活质量和症状严重程度。还记录了同侧肢体复发性 DVT、ECS 使用依从性和其他不良事件。还进行了 logistic 回归分析以确定 PTS 的危险因素。
结果
这项研究共纳入 232 例患者。ECS 组 113 例，对照组 119 例。ECS 组 24 个月时 PTS 发生率为 42.0%，对照组为 57.8%（风险比 [RR]，0.726；95%置信区间 [CI]，0.547-0.964；P =.024）。ECS 组 VEINES-QoL 评分为 63.7±4.6，高于对照组（60.6±6.9；P<0.001）。此外，VEINES-Sym 评分显示 ECS 组患者的症状缓解优于对照组（45.8±5.1 比 43.8±6.1；P=.014）。根据整个队列的 Logistic 回归分析，IFDVT 是 PTS 的危险因素（RR，2.253；95%CI，1.136-4.468），而 ECS 使用的高依从性是保护因素（RR，0.516；95%CI，0.277-0.961）。
结论
这些结果表明，在未接受血栓清除术的 IFDVT 和股腘静脉血栓患者中，ECS 可预防 PTS。
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