下肢深静脉血栓治疗的分析与展望  

Analysis and prospect of lower extremity deep vein thrombosis treatment

作　　者：齐立行[1] 谷涌泉[1] Qi Lixing;Gu Yongquan(Department of Vascular Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院血管外科,北京100053

出　　处：《血管与腔内血管外科杂志》2024年第6期641-645,共5页Journal of Vascular and Endovascular Surgery

基　　金：科技部国家重点研发计划(2021YFC2500504)。

摘　　要：近年来,新技术的进步并未带来下肢深静脉血栓(DVT)疗效的改善,血栓后综合征(PTS)发病率仍较高。各项大型临床研究结果显示,下肢DVT的介入治疗或外科治疗较单纯抗凝治疗无明显优势,国内外相关专业学会发布的指南也有不同意见,给下肢DVT临床治疗决策带来困扰。从血栓病理过程分析,静脉血栓造成炎症反应,损伤静脉壁及瓣膜,血栓逐渐机化使各种疗法效果趋于下降,早期快速血栓清除可中止静脉损伤,减少血栓残余,有效降低PTS发生率。因此,参考患者病程的个体化治疗有望取得更满意的疗效。In recent years,the progress of new technology has not brought about the improvement of the efficacy of lower extremity deep vein thrombosis(DVT),and the incidence of post-thrombotic syndrome(PTS)is still high.The results of various large-scale clinical studies show that interventional or surgical treatment has no obvious advantage over anticoagulation alone of lower extremity DVT.The international guidelines of relevant professional societies also have different opinions,which brings trouble to the clinical treatment decision of lower extremity DVT.From the analysis of the pathological process of thrombosis,venous thrombosis causes inflammation,damages the venous wall and valve,and gradually organization of thrombosis makes the effectiveness of various therapies tend to decline.Early and rapid thrombus removal can stop venous injury,reduce thrombus residual,and effectively reduce the incidence of PTS.Individualized treatment with reference to patients'disease course is expected to achieve more satisfactory efficacy.

关 键 词：深静脉血栓 血栓后综合征 导管溶栓 血栓清除 

分 类 号：R543[医药卫生—心血管疾病]