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深静脉血栓形成的诊断和治疗指南(第三版)
中华医学会外科学分会血管外科学组
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DOI： 10.3760/cma.j.issn.1007-631X.2017.09.032
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摘要

深静脉血栓形成(deep venous thrombosis，DVT)是血液在深静脉内不正常凝结引起的静脉回流障碍性疾病，常发生于下肢。血栓脱落可引起肺动脉栓塞(pulmonary embolism，PE)，DVT与PE统称为静脉血栓栓塞症(venous thromboembolism，VTE)，是同种疾病在不同阶段的表现形式。DVT的主要不良后果是PE和血栓后综合征(post thrombotic syndrome，PTS)，它可以显著影响患者的生活质量，甚至导致死亡。因此，为了提高我国DVT的诊治水平，指导和规范各级医院对DVT的诊治工作，特制订本指南。

引用本文

中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南(第三版)[J]. 中华普通外科杂志,2017,32(9)：807-812.

DOI:10.3760/cma.j.issn.1007-631X.2017.09.032

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深静脉血栓形成(deep venous thrombosis，DVT)是血液在深静脉内不正常凝结引起的静脉回流障碍性疾病，常发生于下肢。血栓脱落可引起肺动脉栓塞(pulmonary embolism，PE)，DVT与PE统称为静脉血栓栓塞症(venous thromboembolism，VTE)，是同种疾病在不同阶段的表现形式。DVT的主要不良后果是PE和血栓后综合征(post thrombotic syndrome，PTS)，它可以显著影响患者的生活质量，甚至导致死亡。因此，为了提高我国DVT的诊治水平，指导和规范各级医院对DVT的诊治工作，特制订本指南。
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参考文献
[1]
Righini M , Le GG , Bounameaux H . Venous thromboembolism diagnosis: unresolved issues[J]. Thromb Haemost, 2015,113(6):1184-1192.
返回引文位置Google Scholar
百度学术
万方数据
[2]
Goldhaber SZ , Bounameaux H . Pulmonary embolism and deep vein thrombosis[J]. Lancet, 2012,379(9828):1835-1846.
返回引文位置Google Scholar
百度学术
万方数据
[3]
Kahn SR , Shrier I , Julian JA ,et al. Determinants and time course of the postthrombotic syndrome after acute deep venous thrombosis[J]. Ann Intern Med, 2008,149(10):698-707.
返回引文位置Google Scholar
百度学术
万方数据
[4]
Tick LW , Kramer MH , Rosendaal FR ,et al. Risk factors for post-thrombotic syndrome in patients with a first deep venous thrombosis[J]. J Thromb Haemost, 2008,6(12):2075-2081.
返回引文位置Google Scholar
百度学术
万方数据
[5]
Carrier M , Le GG , Bates SM ,et al. D-dimer testing is useful to exclude deep vein thrombosis in elderly outpatients[J]. J Thromb Haemost, 2008,6(7):1072-1076.
返回引文位置Google Scholar
百度学术
万方数据
[6]
Wells PS , Anderson DR , Rodger M ,et al. Evaluation of D-dimer in the diagnosis of suspected deep-vein thrombosis[J]. N Engl J Med, 2003,349(13):1227-1235.
返回引文位置Google Scholar
百度学术
万方数据
[7]
Geersing GJ , Zuithoff NP , Kearon C ,et al. Exclusion of deep vein thrombosis using the Wells rule in clinically important subgroups: individual patient data meta-analysis[J]. BMJ, 2014,348:g1340.
返回引文位置Google Scholar
百度学术
万方数据
[8]
Schulman S , Kakkar AK , Goldhaber SZ ,et al. Treatment of acute venous thromboembolism with dabigatran or warfarin and pooled analysis[J]. Circulation, 2014,129(7):764-772.
返回引文位置Google Scholar
百度学术
万方数据
[9]
Harder S . Pharmacokinetic and pharmacodynamic evaluation of rivaroxaban: considerations for the treatment of venous thromboembolism[J]. Thromb J, 2014,12:22.
返回引文位置Google Scholar
百度学术
万方数据
[10]
吴丹明，周玉斌，汤海涛. 下肢深静脉血栓形成的抗凝治疗及其疗程的探讨[J]．中国血管外科杂志(电子版)， 2014,(1):4-6,22.
返回引文位置Google Scholar
百度学术
万方数据
[11]
Arepally GM . Heparin-induced thrombocytopenia[J]. Blood, 2017,129(21):2864-2872.
返回引文位置Google Scholar
百度学术
万方数据
[12]
Krauel K , Hackbarth C , Fürll B ,et al. Heparin-induced thrombocytopenia: in vitro studies on the interaction of dabigatran, rivaroxaban, and low-sulfated heparin, with platelet factor 4 and anti-PF4/heparin antibodies[J]. Blood, 2012,119(5):1248-1255.
返回引文位置Google Scholar
百度学术
万方数据
[13]
Investigators E , Bauersachs R , Berkowitz SD ,et al. Oral rivaroxaban for symptomatic venous thromboembolism[J]. N Engl J Med, 2010,363(26):2499-2510.
返回引文位置Google Scholar
百度学术
万方数据
[14]
Lewis BE , Wallis DE , Berkowitz SD ,et al. Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia[J]. Circulation, 2001,103(14):1838-1843.
返回引文位置Google Scholar
百度学术
万方数据
[15]
中华医学会外科学分会血管外科学组：深静脉血栓形成的诊断和治疗指南(第2版)[J]. 中华普通外科杂志， 2012,27(7):605-607.
返回引文位置Google Scholar
百度学术
万方数据
[16]
Llerena LD , Cáceres-Lóriga FM , Betancourt BY . Recombinant streptokinase: evidences from clinical use[J]. Eur Heart J, 2005,26(14):1448-1450.
返回引文位置Google Scholar
百度学术
万方数据
[17]
Fedullo PF , Konopka RG , Hartman MT ,et al. Thrombolysis with recombinant human tissue type plasminogen activator in a canine model of venous thrombosis[J]. Circulation, 1984,70(6):366.
返回引文位置Google Scholar
百度学术
万方数据
[18]
Grunwald MR , Hofmann LV . Comparison of urokinase, alteplase, and reteplase for catheter-directed thrombolysis of deep venous thrombosis[J]. J Vasc Interv Radiol, 2004,15(4):347-352.
返回引文位置Google Scholar
百度学术
万方数据
[19]
Kearon C , Akl EA , Ornelas J ,et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report[J]. Chest, 2016,149(2):315-352.
返回引文位置Google Scholar
百度学术
万方数据
[20]
王深明，武日东．规范下肢深静脉血栓形成的治疗[J]. 中国血管外科杂志(电子版), 2014,6(1):1-3.
返回引文位置Google Scholar
百度学术
万方数据
[21]
Mewissen MW , Seabrook GR , Meissner MH ,et al. Catheter-directed thrombolysis for lower extremity deep venous thrombosis: report of a national multicenter registry[J]. Radiology, 1999,211(1):39-49.
返回引文位置Google Scholar
百度学术
万方数据
[22]
陈弘，胡楠，孔令尚，等. 不同入路置管溶栓治疗急性下肢深静脉血栓形成[J]．中华普通外科杂志， 2015,30(7):569-570.
返回引文位置Google Scholar
百度学术
万方数据
[23]
褚永新，秦锋，张雷，等. 不同入路置管溶栓治疗急性下肢深静脉血栓形成[J]．中华普通外科杂志， 2017,32(3):228-231.
返回引文位置Google Scholar
百度学术
万方数据
[24]
Rapold HJ , Wu ZM , Stassen T ,et al. Comparison of intravenous bolus injection or continuous infusion of recombinant single chain urokinase-type plasminogen activator (saruplase) for thrombolysis. A canine model of combined coronary arterial and femoral venous thrombosis[J]. Blood, 1990,76(8):1558-1563.
返回引文位置Google Scholar
百度学术
万方数据
[25]
姜坤，李晓强，钱爱民，等. 导管溶栓治疗急性下肢深静脉血栓形成中尿激酶不同给药方式效果比较的临床研究[J]．中国血管外科杂志(电子版)， 2016,8(1):61-63.
返回引文位置Google Scholar
百度学术
万方数据
[26]
Li FH , Zhao Y , Wang XH ,et al. Risk factors associated with symptomatic pulmonary embolism of catheter directed thrombolysis for lower extremity deep venous thrombosis[J]. Eur J Vasc Endovasc Surg, 2015,50(5):658-663.
返回引文位置Google Scholar
百度学术
万方数据
[27]
Sherry S , Gustafson E . The current and future use of thrombolytic therapy[J]. Annu Rev Pharmacol Toxicol, 1985,25:413-431.
返回引文位置Google Scholar
百度学术
万方数据
[28]
McGrath KG , Patterson R . Anaphylactic reactivity to streptokinase[J]. JAMA, 1984,252(10):1314-1317.
返回引文位置Google Scholar
百度学术
万方数据
[29]
Juhan C , Alimi Y , Di MP ,et al. Surgical venous thrombectomy[J]. Cardiovasc Surg, 1999,7(6):586-590.
返回引文位置Google Scholar
百度学术
万方数据
[30]
Karthikesalingam A , Young EL , Hinchliffe RJ ,et al. A systematic review of percutaneous mechanical thrombectomy in the treatment of deep venous thrombosis[J]. Eur J Vasc Endovasc Surg, 2011,41(4):554-565.
返回引文位置Google Scholar
百度学术
万方数据
[31]
Bush RL , Lin PH , Bates JT ,et al. Pharmacomechanical thrombectomy for treatment of symptomatic lower extremity deep venous thrombosis: safety and feasibility study[J]. J Vasc Surg, 2004,40(5):965-970.
返回引文位置Google Scholar
百度学术
万方数据
[32]
Garcia MJ , Lookstein R , Malhotra R ,et al. Endovascular management of deep vein thrombosis with rheolytic thrombectomy: final report of the prospective multicenter PEARL (Peripheral Use of AngioJet Rheolytic Thrombectomy with a Variety of Catheter Lengths) registry[J]. J Vasc Interv Radiol, 2015,26(6):777-786.
返回引文位置Google Scholar
百度学术
万方数据
[33]
Mahnken AH , Thomson K , de Haan M ,et al. CIRSE standards of practice guidelines on iliocaval stenting[J]. Cardiovasc Intervent Radiol, 2014,37(4):889-897.
返回引文位置Google Scholar
百度学术
万方数据
[34]
Mickley V , Schwagierek R , Rilinger N ,et al. Left iliac venous thrombosis caused by venous spur: treatment with thrombectomy and stent implantation[J]. J Vasc Surg, 1998,28(3):492-497.
返回引文位置Google Scholar
百度学术
万方数据
[35]
Kurklinsky AK , Bjarnason H , Friese JL ,et al. Outcomes of venoplasty with stent placement for chronic thrombosis of the iliac and femoral veins: single-center experience[J]. J Vasc Interv Radiol, 2012,23(8):1009-1015.
返回引文位置Google Scholar
百度学术
万方数据
[36]
Kearon C . A conceptual framework for two phases of anticoagulant treatment of venous thromboembolism[J]. J Thromb Haemost, 2012,10(4):507-511.
返回引文位置Google Scholar
百度学术
万方数据
[37]
Falck-Ytter Y , Francis CW , Johanson NA ,et al. Prevention of VTE in orthopedic surgery patients[J]. Chest, 2012,141(Part Ⅱ):e278S-325S.
返回引文位置Google Scholar
百度学术
万方数据
[38]
Dunn A . ACP Journal Club: after initial anticoagulation for a first unprovoked venous thromboembolism, aspirin reduced recurrence[J]. Ann Intern Med, 2015,162(4):JC5.
返回引文位置Google Scholar
百度学术
万方数据
[39]
Bush R , Comerota A , Meissner M ,et al. Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF)[J]. Phlebology, 2017,32(suppl 1):3-19.
返回引文位置Google Scholar
百度学术
万方数据
[40]
Coleridge-Smith P , Lok C , Ramelet AA . Venous leg ulcer: a meta-analysis of adjunctive therapy with micronized purified flavonoid fraction[J]. Eur J Vasc Endovasc Surg, 2005,30(2):198-208.
返回引文位置Google Scholar
百度学术
万方数据
[41]
Pittler MH , Ernst E . Horse chestnut seed extract for chronic venous insufficiency[J]. Cochrane Database Syst Rev, 2012,11:CD003230.
返回引文位置Google Scholar
百度学术
万方数据
[42]
Sirtori CR . Aescin: pharmacology, pharmacokinetics and therapeutic profile[J]. Pharmacol Res, 2001,44(3):183-193.
返回引文位置Google Scholar
百度学术
万方数据
[43]
Andreozzi GM , Bignamini AA , Davì G ,et al. Sulodexide for the prevention of recurrent venous thromboembolism: the Sulodexide in Secondary Prevention of Recurrent Deep Vein Thrombosis (SURVET) Study: a multicenter, randomized, double-blind, placebo-controlled trial[J]. Circulation, 2015,132(20):1891-1897.
返回引文位置Google Scholar
百度学术
万方数据
[44]
Dennis M , Sandercock P , Reid J ,et al. Effectiveness of intermittent pneumatic compression in reduction of risk of deep vein thrombosis in patients who have had a stroke (CLOTS 3): a multicentre randomised controlled trial[J]. Lancet, 2013,382(9891):516-524.
返回引文位置Google Scholar
百度学术
万方数据
[45]
Nakanishi K , Takahira N , Sakamoto M ,et al. Effects of intermittent pneumatic compression of the thigh on blood flow velocity in the femoral and popliteal veins: developing a new physical prophylaxis for deep vein thrombosis in patients with plaster-cast immobilization of the leg[J]. J Thromb Thrombolysis, 2016,42(4):579-584.
返回引文位置Google Scholar
百度学术
万方数据
[46]
Urbankova J , Quiroz R , Kucher N ,et al. Intermittent pneumatic compression and deep vein thrombosis prevention. A meta-analysis in postoperative patients[J]. Thromb Haemost, 2005,94(6):1181-1185.
返回引文位置Google Scholar
百度学术
万方数据
[47]
Hull RD , Raskob GE , Gent M ,et al. Effectiveness of intermittent pneumatic leg compression for preventing deep vein thrombosis after total hip replacement[J]. JAMA, 1990,263(17):2313-2317.
返回引文位置Google Scholar
百度学术
万方数据
[48]
Musani MH , Matta F , Yaekoub AY ,et al. Venous compression for prevention of postthrombotic syndrome: a meta-analysis[J]. Am J Med, 2010,123(8):735-740.
返回引文位置Google Scholar
百度学术
万方数据
[49]
Kahn SR , Shapiro S , Wells PS ,et al. Compression stockings to prevent post-thrombotic syndrome: a randomised placebo-controlled trial[J]. Lancet, 2014,383(9920):880-888.
返回引文位置Google Scholar
百度学术
万方数据
[50]
Kahn SR , Ginsberg JS . The post-thrombotic syndrome: current knowledge, controversies, and directions for future research[J]. Blood Rev, 2002,16(3):155-165.
返回引文位置Google Scholar
百度学术
万方数据
[51]
Villalta S , Bagatella P , Piccioli A . Assessment of validity and reproducibility of a clinical scale for the post-thrombotic syndrome[J]. Haemostasis, 1994,24:158a.
返回引文位置Google Scholar
百度学术
万方数据
[52]
Ginsberg JS , Turkstra F , Buller HR ,et al. Postthrombotic syndrome after hip or knee arthroplasty: a cross-sectional study[J]. Arch Intern Med, 2000,160(5):669-672.
返回引文位置Google Scholar
百度学术
万方数据
[53]
Brandjes DP , Büller HR , Heijboer H ,et al. Randomised trial of effect of compression stockings in patients with symptomatic proximal-vein thrombosis[J]. Lancet, 1997,349(9054):759-762.
返回引文位置Google Scholar
百度学术
万方数据
[54]
Cohen JM , Akl EA , Kahn SR . Pharmacologic and compression therapies for postthrombotic syndrome: a systematic review of randomized controlled trials[J]. Chest, 2012,141(2):308-320.
返回引文位置Google Scholar
百度学术
万方数据
[55]
Kahn SR , Comerota AJ , Cushman M ,et al. The postthrombotic syndrome: evidence-based prevention, diagnosis, and treatment strategies: a scientific statement from the American Heart Association[J]. Circulation, 2014,130(18):1636-1661.
返回引文位置Google Scholar
百度学术
万方数据
[56]
中华医学会外科分会血管外科学组．慢性下肢静脉疾病诊断与治疗中国专家共识[J]. 中华普通外科杂志， 2014,29(4):246-252.
返回引文位置Google Scholar
百度学术
万方数据
[57]
Rosales A , Sandbaek G , Jørgensen JJ . Stenting for chronic post-thrombotic vena cava and iliofemoral venous occlusions: mid-term patency and clinical outcome[J]. Eur J Vasc Endovasc Surg, 2010,40(2):234-240.
返回引文位置Google Scholar
百度学术
万方数据
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