深静脉血栓后综合征的病理生理学改变和系统性防治理念  

Pathophysiological changes and systemic prevention and treatment of deep vein post-thrombotic syndrome

作　　者：张蕴鑫 陈小丫 汤迎磊 刘佳 刘建龙[1] Zhang Yunxin;Chen Xiaoya;Tang Yinglei;Liu Jia;Liu Jianlong(Department of Vascular Surgery,Beijing Jishuitan Hospital,Beijing 100035,China;Department of Biomedical Engineering,Tianjin Medical University,Tianjin 300070,China;Department of Clinical Medicine,College of Binzhou Medical University,Binzhou 256600,Shandong,China;Department of Clinical Medicine,Jining Medical College,Jining 272000,Shandong,China)

机构地区：[1]北京积水潭医院血管外科,北京100035 [2]天津医科大学生物医学工程系,天津300070 [3]滨州医学院临床医学系,山东滨州256600 [4]济宁医学院临床医学系,山东济宁272000

出　　处：《血管与腔内血管外科杂志》2022年第12期1477-1482,共6页Journal of Vascular and Endovascular Surgery

基　　金：吴阶平医学基金会临床科研专项资助基金(320.6750.2021-24-3)。

摘　　要：深静脉血栓后综合征(PTS)是下肢深静脉血栓慢性期最严重的并发症,发病率高,通常表现为下肢肿胀疼痛、足靴区色素沉着、间歇性跛行、静脉曲张、淤积性皮炎甚至慢性溃疡形成,而溃疡经久不愈会导致肢体活动功能障碍、残疾甚至高位截肢,严重影响患者的生活质量。深静脉PTS的病理生理机制较为复杂,影响因素较多,治疗效果不佳,因此,在临床诊疗过程中需要重视建立全程性系统防治理念,以预防为主,治疗为辅,于血栓急性期最大程度地进行血栓清除与管腔重塑,给予足量的抗凝药物治疗,辅以压力治疗、功能锻炼及抗炎药物治疗等,术后严密监测,慢性期联合运用球囊扩张成形术及支架置入术等手段,才能真正解决患者的实际需求。With higher incidence, deep vein post-thrombotic syndrome(PTS) is the most serious complication in the chronic stage of lower extremity deep vein thrombosis, characterized by lower extremity swelling and pain,pigmentation of lower portion leg, intermittent claudication, varicose veins, stasis dermatitis, and refractory ulcer, long lasting ulcer may lead to physical activity dysfunction, disability and even higher amputation, subsequently affecting the patient’s quality of life. The therapeutic outcome of PTS is unfavorable resulting from its complex pathophysiological development process and various influencing factors. Clinical practice should attach great importance to the establishment of systematic prevention and treatment concept. Prevention is of top priority with treatment as assistance.In the acute stage of thrombosis, thrombus clearance, lumen remodeling, effective anticoagulation, pressure therapy,functional exercise, anti-inflammatory drug, and postoperative close monitoring, and in the chronic stage, the balloon dilatation and stent placement can effectively meet the actual needs of patients.

关 键 词：深静脉血栓后综合征 深静脉血栓形成 压力袜 

分 类 号：R543[医药卫生—心血管疾病]