最后审阅: 18 九月 2021
最后更新: 12 三月 2021

小结

定义

病史和体格检查

关键诊断因素

  • 既往有静脉血栓栓塞、易栓症、恶性肿瘤、手术后、外伤以及中心静脉置管
  • 慢性疾病、麻痹、高龄、肥胖、含雌激素避孕药和激素替代治疗、静脉曲张、妊娠和产后 ≤ 6 周、一级亲属有 VTE 病史、长时间旅行以及入院接受重症监护治疗

危险因素

  • 既往静脉血栓栓塞(深静脉血栓形成 [DVT] 和/或肺栓塞 [PE])
  • 血栓形成倾向
  • 恶性肿瘤
  • 术后情况
  • 外伤
  • 内置的中心导管(上肢或下肢)
  • 丧失活动能力
  • 骨髓增生性疾病
  • 充血性心力衰竭
  • 慢性阻塞性肺疾病
  • 炎症性肠病
  • 肢体轻度瘫痪患者的神经系统疾病
  • 年龄增长
  • 肥胖
  • 含雌激素避孕药、激素替代治疗(HRT)和雄激素剥夺治疗
  • 静脉曲张病史
  • 妊娠/产后
  • 长途旅行
  • 小腿固定
  • 一级亲属有 VTE 病史
  • 入院接受重症监护

诊断性检查

首要检查

  • 全血细胞计数 (FBC)
  • 血清肌酐
  • INR
  • PTT

需考虑的检查

  • 血清抗血小板因子4抗体

治疗流程

撰稿人

作者

Nathalie Routhier, MD, MSc, FRCPC

Attending Physician

Assistant Professor

University of Montreal

Montreal

Canada

利益声明

NR declares that she has no competing interests.

Vicky Tagalakis, MD, FRCPC, MSC
Vicky Tagalakis

Associate Professor

General Internal Medicine Program Director

McGill University Division of Internal Medicine

Centre for Clinical Epidemiology of the Lady Davis Institute for Medical Research

Jewish General Hospital

Montreal

Canada

利益声明

VT declares that she has received an investigator-initiated grant from Sanofi-Aventis. She has also received consultancy fees from and given lectures sponsored by Bristol-Myers Squibb, Pfizer, Sanofi-Aventis, and Servier. VT is an author of references cited in this topic.

鸣谢

Dr Nathalie Routhier and Dr Vicky Tagalakis would like to gratefully acknowledge Dr Vincent Bouchard-Dechêne and Dr Adi J. Klil-Drori, previous contributors to this topic.

利益声明

VBD and AJKD declare no competing interests.

同行评议者

Andrew Parfitt, MBBS, FFAEM

Clinical Director

Acute Medicine

Associate Medical Director

Consultant Emergency Medicine

Guy's and St Thomas' NHS Foundation Trust

Clinical Lead and Consultant

Accident Emergency Medicine

St Thomas' Hospital

London

UK

利益声明

AP declares that he has no competing interests.

Sudeep Shivakumar, MD

Hematologist

Thrombosis Fellow

University of Ottawa

Ottawa Health Research Institute

Ottawa

Canada

利益声明

SS declares that he has no competing interests.

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