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Superficial vein thrombosis

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
最后审阅： 26 Sep 2025
最后更新： 08 Mar 2024

小结

定义

病史和体格检查

关键诊断因素

  • previous superficial vein thrombosis (SVT), deep vein thrombosis, or pulmonary embolism
  • redness/erythema of overlying skin
  • hot/warm overlying skin
  • painful/tender over affected vein
  • swelling/edema of surrounding area
  • cord-like mass palpable
  • development of symptoms over hours to days
  • signs/symptoms of concomitant DVT or PE
完整详情

其他诊断因素

  • varicose veins
  • history of thrombophilic disorders
  • autoimmune diseases (e.g., Behcet and Buerger disease)
  • recent vein instrumentation (e.g., sclerotherapy)
  • recent vein catheterization and intravenous drug administration
  • low-grade fever
  • pigmentation changes
完整详情

危险因素

  • varicose veins
  • thrombophilic disorders
  • autoimmune diseases (e.g., Behcet and Buerger disease)
  • prior history of superficial vein thrombosis (SVT)
  • female sex
  • sclerotherapy
  • intravenous catheterization
  • malignancy
  • pregnancy
  • use of oral contraceptives (OCPs) and hormonal replacement therapy
  • older age
  • history of prior venous thromboembolism (VTE), including deep vein thrombosis and PE
  • obesity
  • prolonged immobilization (e.g., long-haul air travel)
  • blood type
完整详情

诊断性检查

首要检查

  • Doppler ultrasonography
完整详情

需考虑的检查

  • biopsy
  • pulmonary CT angiography
  • ventilation perfusion (VQ) scan
  • conventional pulmonary angiography
  • assessment for malignancy
  • thrombophilia screening
完整详情

治疗流程

初步治疗

extension into the femoral vein or popliteal vein, thrombus ≤3 from the saphenofemoral or saphenopopliteal junction, or concomitant DVT or PE

急症处理

nonpregnant: SVT ≥5 cm in length within axial superficial vein and >3 cm from the saphenofemoral or saphenopopliteal junction

nonpregnant: SVT <5 cm in length within axial superficial vein or thrombus within tributary varicose veins only

pregnant: SVT (any size) within axial or tributary vein

持续性治疗

incompetent saphenous vein with associated varicose veins or recurrent SVT

撰稿人

作者

Sherry Scovell, MD, FACS

Vascular and Endovascular Surgeon

Massachusetts General Hospital

Assistant Professor of Surgery, Part Time

Harvard Medical School

Boston

MA

利益声明

SS is an author for UpToDate, which is compensated. SS declares that she has no conflicts of interest with medical or pharmaceutical companies.

鸣谢

Dr Sherry Scovell would like to gratefully acknowledge Professor Vicky Tagalakis, a previous contributor to this topic.

利益声明

VT has received reimbursement for advisory board work for Servier and Pzifer. Both of these companies are makers of anticoagulants. VT has received an investigator-initiated grant from Sanofi, manufacturer of Enoxaparin.

同行评议者

Francois Becker, MD, PhD

Consultant

Division of Angiology and Hemostasis

University Hospital of Geneva

Geneva

Switzerland

利益声明

FB declares that he has no competing interests.

Michael Bromberg, MD, PhD

Professor of Medicine

Section of Hematology

Director of Hematologic Malignancies

Temple University School of Medicine

Philadelphia

PA

利益声明

MB declares that he has no competing interests.

Louis Aledort, MD

The Mary Weinfeld Professor of Clinical Research in Hemophilia

Mount Sinai School of Medicine

New York

NY

利益声明

LA declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Stevens SM, Woller SC, Kreuziger LB, et al. Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest. 2021 Dec;160(6):e545-608.全文  摘要

Kakkos SK, Gohel M, Baekgaard N, et al. Editor's Choice - European Society for Vascular Surgery (ESVS) 2021 clinical practice guidelines on the management of venous thrombosis. Eur J Vasc Endovasc Surg. 2021 Jan;61(1):9-82.全文  摘要

Thrombosis Canada. Superficial thrombophlebitis, superficial vein thrombosis. Aug 2023 [internet publication].全文

Di Nisio M, Wichers IM, Middeldorp S. Treatment for superficial thrombophlebitis of the leg. Cochrane Database Syst Rev. 2018 Feb 25;(2):CD004982.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Superficial vein thrombosis images

  • 鉴别诊断

    • Deep vein thrombosis
    • Cellulitis
    • Lymphedema
    更多 鉴别诊断

  • 指南

    • Superficial thrombophlebitis, superficial vein thrombosis
    • Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report​
    更多 指南

  • 患者教育信息

    Deep vein thrombosis

    Varicose veins

    更多 患者教育信息
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