Bounameaux H
Département de médicine interne, Hôpital Cantonal Universitaire de Genève, Genève.
Ther Umsch. 1996 Apr;53(4):272-6.
The cornerstone of therapy of deep venous thrombosis (DVT) of the lower extremities is anticoagulation. Surgical thrombectomy and thrombolytic treatment are restricted to a small number of selected patients. Anticoagulation is started either with unfractionated heparin (continuous intravenous infusion or subcutaneous injection b.i.d.) with dose adjustments according to the partial thromboplastin time (PTT), or with subcutaneous injections of low-molecular-weight heparin (LMWH) in one or two daily injections without laboratory monitoring. This initial treatment is rapidly followed and replaced by oral anticoagulants at an intensity corresponding to an International Normalized Ratio (I.N.R.) of 2-3 and for a duration of about 3 months after a first episode of proximal DVT. This duration should be modulated on an individual basis according to the risks of recurrent thromboembolism and hemorrhage.
下肢深静脉血栓形成（DVT）治疗的基石是抗凝治疗。手术取栓和溶栓治疗仅限于少数经过挑选的患者。抗凝治疗可起始于普通肝素（持续静脉输注或每日两次皮下注射），根据部分凝血活酶时间（PTT）调整剂量；也可采用低分子肝素（LMWH）皮下注射，每日一次或两次，无需实验室监测。初始治疗后应迅速给予口服抗凝药，强度对应国际标准化比值（I.N.R.）为2 - 3，首次发生近端DVT后持续约3个月。此后，应根据复发性血栓栓塞和出血风险进行个体化调整疗程。
