骨科患者罹患小腿肌间静脉血栓的临床诊疗进展

发布时间：2018-02-02 14:12

本文关键词： 静脉血栓形成骨科小腿肌间静脉诊疗　出处：《中华临床医师杂志(电子版)》2016年14期 　论文类型：期刊论文

【摘要】：随着超声检查的广泛应用及骨科医师对下肢深静脉血栓(DVT)认识的提高,越来越多的骨科患者在围手术期内被诊断出患有小腿肌间静脉血栓(CMVT)。关于CMVT最早是由英国学者于1965年提出,但我们对CMVT的认识才刚刚开始。尤其是对于骨科医师在临床工作中遇到罹患CMVT的患者该如何应对、诊治方法是否有别于较大的DVT、骨科手术前是否必须通过安置下腔静脉滤器来预防肺栓塞等疑问,相关指南并未给出明确指导意见,相关研究也未达成共识。有国外学者认为,CMVT能够自然消融,很少会发生肺栓塞等严重并发症;而另有一项研究表明,在发生肺栓塞的患者中,约有5%~33%与CMVT相关。由于一旦发生肺栓塞会严重危及患者生命安全,因此骨科医师在围手术期内应对罹患CMVT的患者给予足够的重视,使患者安全度过围手术期。本文就CMVT的临床诊疗进展作一综述。
[Abstract]:With the extensive application of ultrasound examination and the improvement of the understanding of DVT by orthopaedic doctors. More and more orthopaedic patients have been diagnosed with intermuscular venous thrombosis in the leg during perioperative period. CMVT was first proposed by British scholars in 1965. But our understanding of CMVT is just beginning. Especially for orthopaedic physicians in clinical work with patients with CMVT how to deal with, whether the diagnosis and treatment methods are different from the larger DVT. Before orthopedic surgery, there is no clear guidance on whether or not pulmonary embolism should be prevented by placement of IVC filters, and there is no consensus on the relevant research. Some foreign scholars believe that it is necessary to put in place IVC filters before orthopedic surgery to prevent pulmonary embolism. CMVT can be ablated naturally with few serious complications such as pulmonary embolism. Another study showed that about 53% of patients with pulmonary embolism were associated with CMVT. Therefore, orthopedic surgeons should pay enough attention to the patients with CMVT during perioperative period so that the patients can survive the perioperative period safely. This article reviews the progress of clinical diagnosis and treatment of CMVT.
【作者单位】：山西医科大学;山西医学科学院山西大医院骨科;
【分类号】：R687;R543.6
【正文快照】： 小腿肌间静脉血栓(calf muscular veinthrombosis,CMVT)属于下肢深静脉血栓(deep veinthrombosis,DVT)中的周围型,其泛指小腿比目鱼肌及腓肠肌静脉丛血管内的血栓。它是DVT的好发部位,其中又以比目鱼肌静脉丛血栓最为常见[1]。骨科患者常因术前疼痛、活动减少以及手术后制动等

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