最近审阅: 1 十一月 2020
最近更新: 27 八月 2019

小结

定义

病史和体格检查

关键诊断因素

  • 小腿肿胀
  • 沿着深静脉走向的局部疼痛

其他诊断因素

  • 非对称性水肿
  • 浅静脉突出
  • 全腿肿胀
  • 股青肿

危险因素

  • 过去两个月内住院史
  • 3 个月内的大型手术史
  • 活动性肿瘤
  • 下肢创伤
  • 严重创伤
  • 年龄增长
  • 妊娠
  • 凝血因子 V Leiden
  • 凝血酶原基因突变 G20210A
  • 蛋白 C/S 缺乏
  • 抗凝血酶缺乏
  • 抗磷脂抗体综合征
  • 内科合并症
  • 特定药物的使用
  • 肥胖
  • 近期长距离空中旅行
  • 家族史
  • 吸烟

诊断性检查

首要检查

  • Wells 评分
  • D-二聚体水平定量检测
  • 近端多普勒超声
  • 全腿超声检查
  • 国际标准化比率和活化部分凝血活酶时间
  • 尿素和肌酐
  • 肝功能检查 (LFT)
  • 全血细胞计数(FBC)
更多 首要检查

需考虑的检查

  • 多普勒静脉血流测定
  • 腹部和盆腔 CT 造影增强扫描
  • 血栓形成倾向的筛查
更多 需考虑的检查

治疗流程

撰稿人

Director

Thrombosis Clinic

Intermountain Medical Center

Murray

Professor of Medicine

University of Utah

Salt Lake City

UT

利益声明

SMS’ institution has received financial support for his conduct of investigator-initiated research from Pfizer/Bristol-Myers Squibb.

Director

Thrombosis Clinic

Intermountain Medical Center

Murray

Professor of Medicine

University of Utah

Salt Lake City

UT

利益声明

SCW holds two investigator-initiated grants from Bristol-Myers Squibb/Pfizer paid to his employer Intermountain Healthcare for which he receives no compensation. He has been invited to serve as co-chair of the American College of Chest Physicians guideline on antithrombotic therapy for venous thromboembolic disease ('AT11') and serves as an invited panelist for the US Centers for Disease Control and Prevention venous thromboembolism risk assessment model systematic review and guidance panel.

Clinical Coordinator

Critical Care Pharmacy

Advanced Clinical Pharmacist

Neuroscience Critical Care

Intermountain Medical Center

Murray

UT

利益声明

GVF receives consulting fees and honoraria from Portola Pharmaceuticals for clinical consulting and speaking engagements.

Dr Scott M. Stevens, Dr Scott C. Woller, and Dr Gabriel V. Fontaine would like to gratefully acknowledge Dr Geno Merli, Dr Taki Galanis, Dr Luis Eraso, Dr Geoffrey Ouma, Dr Richard White, and Dr Windsor Ting, the previous contributors to this topic. GM has received grant or research support from BMS, J&J, Sanofi-Aventis, Portola, and Janssen; he has served as a Scientific Consultant for BMS, J&J, and Sanofi-Aventis. RW declares participation in numerous multicentred clinical trials sponsored by companies: Agenix, Boehringer-Ingleheim, Amgen, Bayer, Bristol-Meyer-Squibb, Novartis, Hemosense. TG, LE, GO, and WT declare that they have no competing interests.

同行评议者展开全部内容

Professor of Thrombosis & Haemostasis

King's College

Consultant

Departments of Haematology, Pathology & Rheumatology

Lead in Blood Sciences

Guy's & St Thomas' NHS Foundation Trust

London

UK

利益声明

BH declares that she has no competing interests.

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