Turpie A G
Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
Semin Thromb Hemost. 1997;23(2):155-7. doi: 10.1055/s-2007-996084.
Venous thromboembolism is a common complication in patients with acute thrombotic stroke. Estimates of the frequency of deep vein thrombosis (DVT) in untreated patients range from 20 to 75%. This wide range reported depends on the methods used to detect DVT and, importantly, on the degree of lower limb paralysis. Most thrombi occur in the paralyzed limbs in which the frequency ranges from 60 to 75%. Of these thrombi, 25% occur in the proximal segment and present a high risk for pulmonary embolism. Indeed, pulmonary embolism is the third most common cause of death in stroke patients and occurs in 1 to 2% of patients who do not receive prophylaxis. A number of methods of preventing DVT have been shown to be safe and effective in stroke patients. These include low-dose heparin, low-molecular-weight heparin, and a heparinoid. Of these, the data with the heparinoid danaparoid provide the most solid evidence for efficacy, and in comparative trials it has been shown to be more effective than heparin.
静脉血栓栓塞是急性血栓性卒中患者的常见并发症。未经治疗的患者深静脉血栓形成（DVT）的发生率估计在20%至75%之间。报告的这一广泛范围取决于检测DVT所使用的方法，重要的是，还取决于下肢瘫痪的程度。大多数血栓发生在瘫痪肢体，其发生率在60%至75%之间。在这些血栓中，25%发生在近端节段，存在发生肺栓塞的高风险。事实上，肺栓塞是卒中患者第三大常见死因，在未接受预防措施的患者中发生率为1%至2%。已证明多种预防DVT的方法在卒中患者中是安全有效的。这些方法包括小剂量肝素、低分子量肝素和类肝素。其中，类肝素达那肝素的数据提供了最确凿的疗效证据，在比较试验中已证明其比肝素更有效。
