Bounameaux H, Reber-Wasem M A
Department of Internal Medicine, University Hospital of Geneva, Switzerland.
Arch Intern Med. 1997 Sep 8;157(16):1822-4.
Superficial thrombophlebitis is a common and benign disease. However, an association with deep vein thrombosis, a more severe condition that requires anticoagulant treatment, has been reported repeatedly with frequencies ranging from 12% to 44%.
All consecutive records of patients with lower limb superficial thrombophlebitis were retrieved from the laboratory database over a 6-year period (1989-1994), and association with deep vein thrombosis was sought. Also, to detect late events, consultations were registered over a 3-month period after the initial examination. Patients with the association of superficial thrombophlebitis and deep vein thrombosis were also compared with a randomly selected sample of subjects with superficial thrombophlebitis only.
Objectively confirmed deep vein thrombosis was detected in 31 patients (5.6%; 95% confidence interval, 3.8%-7.9%). Additional late thromboembolic events were detected in 1.7% of the patients during the 3-month follow-up period. Previous immobilization was more common among patients with deep vein thrombosis associated with superficial phlebitis (11/31, 36%) than among a randomly selected subset of patients with superficial thrombophlebitis only (13/93, 14%), the difference being statistically significant (P < .02).
When large populations of patients with superficial thrombophlebitis are studied, the association with deep vein thrombosis appears rather small. Thus, systematic screening for deep vein thrombosis may not be warranted in the presence of superficial thrombophlebitis unless additional risk factors (eg, immobilization) are present.
浅静脉血栓形成是一种常见的良性疾病。然而，反复有报道称其与深静脉血栓形成有关，后者是一种更严重的疾病，需要进行抗凝治疗，报道的相关频率在12%至44%之间。
从实验室数据库中检索了6年期间（1989 - 1994年）所有下肢浅静脉血栓形成患者的连续记录，并探寻其与深静脉血栓形成的关联。此外，为了检测晚期事件，在初次检查后的3个月期间记录会诊情况。还将浅静脉血栓形成与深静脉血栓形成相关的患者与仅随机选取的浅静脉血栓形成患者样本进行了比较。
在31例患者中检测到客观证实的深静脉血栓形成（5.6%；95%置信区间，3.8% - 7.9%）。在3个月的随访期内，1.7%的患者检测到额外的晚期血栓栓塞事件。与浅静脉炎相关的深静脉血栓形成患者中，既往制动情况比仅随机选取的浅静脉血栓形成患者子集更常见（11/31，36%对比13/93，14%），差异具有统计学意义（P < 0.02）。
当研究大量浅静脉血栓形成患者时，其与深静脉血栓形成的关联似乎较小。因此，在存在浅静脉血栓形成时，除非存在其他危险因素（如制动），否则可能无需对深静脉血栓形成进行系统筛查。
