下肢静脉疾病介入术后的药物治疗方案  

Medication regimen for lower extremity venous diseases after endovascular interventional surgery

作　　者：李世伦 李一男[1] 倪其泓[1] 张岚[1] LI Shilun;LI Yinan;NI Qihong;ZHANG Lan(Department of Vascular Surgery,Affiliated Renji Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院血管外科,上海200127

出　　处：《介入放射学杂志》2023年第7期715-718,共4页Journal of Interventional Radiology

基　　金：国家自然科学基金(82170511)。

摘　　要：下肢静脉疾病在我国的发生率逐年增加,腔内介入术后联合药物治疗是急性下肢深静脉血栓形成、血栓形成后综合征和非血栓性髂静脉压迫的综合治疗方案。药物治疗包括抗凝药物和静脉活性药物等,这些药物对患者确有获益但具体剂量和疗程选择尚存争议,本文总结并分析了近年关于下肢静脉疾病介入术后的药物治疗方案,探讨临床较为满意的药物治疗方案。推荐急性下肢深静脉血栓形成患者至少应持续抗凝3个月,推荐使用直接口服抗凝药抗凝治疗;血栓形成后综合征患者推荐低分子肝素或直接口服抗凝药足量抗凝,联合静脉活性药物治疗6~12个月;非血栓性髂静脉压迫患者可采取多种抗凝、抗血小板方案,均可取得较为满意的效果。The incidence of lower limb venous diseases in China is increasing year by year.Endovascular intervention combined with postoperative drug therapy is a comprehensive scheme for acute deep vein thrombosis of the lower limbs,post-thrombosis syndrome,and non-thrombotic iliac vein compression syndrome.Medication includes anticoagulants,intravenous active drugs,etc.The use of these drugs does benefit the patients,however,the specific dosage and the selection of treatment course are still controversial.Based on the recent advances in medication programs for lower limb venous diseases after endovascular intervention,this paper aims to make a comprehensive review about the clinically satisfactory medication regimens.For the patients with acute lower limb deep vein thrombosis,anticoagulation should be kept on for at least 3 months,and direct oral anticoagulants is recommended;for the patients with post-thrombosis syndrome,the use of low molecular weight heparin(LMWH)or direct oral full dose anticoagulant combined with the intravenous active drugs for 6-12 months is recommended;and for the patients with non-thrombotic iliac vein compression syndrome,a variety of anticoagulation,antiplatelet regimens can be adopted,all of which can achieve satisfactory results.(J Intervent Radiol,2023,32:715-718)

关 键 词：下肢静脉疾病 腔内介入术后 直接口服抗凝药 血管活性药物 

分 类 号：R543.6[医药卫生—心血管疾病]