Ikeda M, Kambayashi J, Iwamoto S, Shinoki N, Nakamura T, Okahara K, Fujitani K, Shibuya T, Kawasaki T, Monden M
Department of Surgery II, Osaka University Medical School, Japan.
Thromb Res. 1996 Apr 1;82(1):87-95. doi: 10.1016/0049-3848(96)00054-0.
The influence of compression sclerotherapy upon hemostasis activation was investigated in 41 consecutive patients with lower extremity varices by serial measurement of thrombin-antithrombin III complexes (TAT), D-dimer, fibrinogen and C-reactive protein (CRP). Blood sampling was carried out before operation and on the 7th and 28th post-operative day in patients randomly assigned to either the control group (n = 18), in which high ligation of sapheno-femoral junction and local excision of varices were performed, or the sclerotherapy group (n = 23) in which the comparable surgical intervention and compression sclerotherapy using hypertonic saline were performed simultaneously. In both groups, the TAT, D-dimer and fibrinogen concentrations at day 7 were significantly elevated compared to the value before operation while CRP showed no significant change during the observation period. In the sclerotherapy group, higher incidence of superficial thrombosis was observed and the TAT concentration at day 7 was significantly higher than that in the control group (p < 0.01), and the TAT at day 28 was still significantly elevated compared to the pre-operative level (p < 0.05). However, no relationship between TAT and D-dimer concentrations and the extent of superficial thrombosis was observed. We conclude that compression sclerotherapy for lower extremity varices causes latent activation of coagulation system and can be a risk factor for venous thromboembolism.
通过连续测量凝血酶 - 抗凝血酶III复合物（TAT）、D - 二聚体、纤维蛋白原和C反应蛋白（CRP），对41例连续性下肢静脉曲张患者进行研究，以探讨压迫硬化疗法对止血激活的影响。将患者随机分为对照组（n = 18）和硬化疗法组（n = 23），在手术前、术后第7天和第28天进行采血。对照组行大隐静脉 - 股静脉交界处高位结扎及曲张静脉局部切除术；硬化疗法组在进行类似手术干预的同时，使用高渗盐水进行压迫硬化疗法。两组患者术后第7天的TAT、D - 二聚体和纤维蛋白原浓度均较术前显著升高，而CRP在观察期内无显著变化。硬化疗法组观察到较高的浅表血栓形成发生率，术后第7天的TAT浓度显著高于对照组（p < 0.01），术后第28天的TAT仍较术前水平显著升高（p < 0.05）。然而，未观察到TAT和D - 二聚体浓度与浅表血栓形成程度之间的关系。我们得出结论，下肢静脉曲张的压迫硬化疗法会导致凝血系统的潜在激活，可能是静脉血栓栓塞的危险因素。
