静脉血栓形成的诊断准确性
Diagnostic accuracy in venous thrombosis.
作者信息
Lambie J M, Mahaffy R G, Barber D C, Karmody A M, Scott M M, Matheson N A
出版信息
Br Med J. 1970 Apr 18;2(5702):142-3. doi: 10.1136/bmj.2.5702.142.
A group of 111 surgical patients at high risk of venous thrombosis were studied after operation by independent clinical assessment and with (125)I-fibrinogen to detect venous thrombosis. Almost half of the patients developed venous thrombosis. Of these, two-thirds were not suspected clinically despite careful scrutiny. In the patients in whom a clinical diagnosis of venous thrombosis was made this diagnosis was falsely positive in a quarter. More than half of all thrombotic episodes were detectable on the day after operation.The prevalence of venous thrombosis, together with the difficulty in diagnosing it, strongly supports the argument that a reduction in the incidence of pulmonary embolism must depend on widespread adoption of effective prophylaxis, especially in the large number of patients at high risk of venous thrombosis. Prophylactic trials must be objectively assessed, and it is in this field that the (125)I-fibrinogen technique probably has the most to offer.
对111名静脉血栓形成高危手术患者术后进行了独立临床评估，并使用（125）I - 纤维蛋白原检测静脉血栓形成情况。几乎一半的患者发生了静脉血栓形成。其中，尽管经过仔细检查，仍有三分之二在临床上未被怀疑。在临床诊断为静脉血栓形成的患者中，四分之一的诊断为假阳性。超过一半的血栓形成事件在术后第一天即可检测到。静脉血栓形成的患病率以及诊断的困难，有力地支持了这样一种观点，即降低肺栓塞的发生率必须依赖于广泛采用有效的预防措施，尤其是在大量静脉血栓形成高危患者中。预防性试验必须进行客观评估，而在这一领域，（125）I - 纤维蛋白原技术可能最有帮助。
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