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[盆腔静脉血栓形成:当前的治疗选择及再通程序的重要性]

[Pelvic vein thrombosis : Current treatment options and importance of recanalization procedures].

作者信息

Jung G, Breiding P S, Schmitz-Rixen T, Hakimi M

机构信息

Klinik für Gefässchirurgie, Luzerner Kantonsspital, Spitalstr., 6000, Luzern 16, Schweiz.

Radiologie, Sektion interventionelle Radiologie, Luzerner Kantonsspital, Spitalstr., 6000, Luzern 16, Schweiz.

出版信息

Chirurgie (Heidelb). 2024 Jan;95(1):87-98. doi: 10.1007/s00104-023-01964-0. Epub 2023 Oct 4.

Abstract

Venous thrombosis is a frequent disorder. A distinction is made between an acute phase of the disease and a chronic manifestation, the postthrombotic syndrome. In particular, proximal venous thrombosis/pelvic vein thrombosis can cause a life-threatening pulmonary embolism during the acute phase of the disease. The postthrombotic syndrome is characterized by the remodeling of the affected venous section, which is often caused by inflammation. Locally, the typical clinical finding is caused by scarred stricture of the vein with restricted drainage and peripheral venous hypertension. Acute thrombosis should be primarily treated by therapeutic anticoagulation and compression therapy of the affected extremity. The duration of these measures depends on clinical presentation, cause (provoked, unprovoked) and risk factors for venous thrombosis/recurrent thrombosis. Venous revascularization procedures are important both in the acute phase of the disease and in the treatment of postthrombotic syndrome. The recanalization treatment is mostly carried out as an endovascular or hybrid intervention and venous bypass procedures are reserved for special situations.

摘要

静脉血栓形成是一种常见疾病。该疾病分为急性期和慢性表现,即血栓形成后综合征。特别是近端静脉血栓形成/盆腔静脉血栓形成在疾病急性期可导致危及生命的肺栓塞。血栓形成后综合征的特征是受累静脉段的重塑,这通常由炎症引起。在局部,典型的临床发现是由静脉瘢痕性狭窄导致引流受限和外周静脉高压引起的。急性血栓形成应主要通过治疗性抗凝和对受累肢体进行压迫治疗。这些措施的持续时间取决于临床表现、病因(诱发、非诱发)以及静脉血栓形成/复发性血栓形成的危险因素。静脉血运重建手术在疾病急性期和血栓形成后综合征的治疗中都很重要。再通治疗大多作为血管内或混合干预进行,静脉搭桥手术则留作特殊情况使用。

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