Janssen M C, Wollersheim H, Nováková I R, Heystraten F M, van Asten W N, Thien T
Department of Medicine, University Hospital, Nijmegen, Netherlands.
Neth J Med. 1996 Mar;48(3):109-21. doi: 10.1016/0300-2977(95)00059-3.
Because clinical signs and symptoms are unreliable the diagnosis of deep vein thrombosis (DVT) should be objectified. Advantages and disadvantages of contrast venography, plethysmography, ultrasound techniques, fibrinogen leg scanning, computer-assisted tomography, magnetic resonance imaging and blood tests are discussed. In patients with a first event of suspected DVT non-invasive methods like serial plethysmography or ultrasound testing are sensitive and specific enough to make a treatment decision. It is safe to withhold anticoagulants if the test remains normal within 1 week. In patients with suspected recurrent DVT new non-invasive techniques are being tested, but up to now the definitive objective diagnostic test continues to be contrast venography. In first period as well as in recurrent DVT D-Dimer testing could be an additional test to exclude active thromboembolism.
由于临床体征和症状不可靠，深静脉血栓形成（DVT）的诊断应客观化。本文讨论了静脉造影、体积描记法、超声技术、纤维蛋白原腿部扫描、计算机断层扫描、磁共振成像和血液检测的优缺点。对于首次发生疑似DVT的患者，连续体积描记法或超声检测等非侵入性方法足够敏感和特异，足以做出治疗决策。如果检测在1周内保持正常，停用抗凝剂是安全的。对于疑似复发性DVT的患者，正在测试新的非侵入性技术，但到目前为止，确定性的客观诊断测试仍然是静脉造影。在首次发作以及复发性DVT中，D - 二聚体检测可能是排除活动性血栓栓塞的一项附加检测。
