BMJ Best Practice
最后审核时间: 十月 2018
最近更新时间: 一月 2018

小结

定义

病史和查体

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
  • 全腿肿胀
  • 股青肿
  • 侧支表浅静脉扩张

危险因素

  • 过去2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

诊断性检查

首要检查

  • Wells的临床可能性分析工具
  • D-二聚体水平定量检测
  • 静脉多普勒超声
  • 国际标准化比率和活化部分凝血活酶时间
全部具体信息

需要考虑的检查

  • 多普勒静脉血流测定
  • 腹部和盆腔CT增强对比扫描
  • 血栓形成倾向的筛查
全部具体信息

治疗流程

贡献者

Professor of Medicine and Surgery

Section of Vascular Medicine, Department of Surgery

Co-Director

Jefferson Vascular Center

Sidney Kimmel Medical College at Thomas Jefferson University

Thomas Jefferson University Hospitals

Philadelphia

PA

利益冲突披露
GM declares that he has no competing interests.

Assistant Professor of Medicine and Surgery

Section of Vascular Medicine, Department of Surgery

Sidney Kimmel Medical College at Thomas Jefferson University

Thomas Jefferson University Hospitals

Philadelphia

PA

利益冲突披露
TG declares that he has no competing interests.

Assistant Professor of Medicine and Surgery

Section of Vascular Medicine, Department of Surgery

Sidney Kimmel Medical College at Thomas Jefferson University

Thomas Jefferson University Hospitals

Philadelphia

PA

利益冲突披露
LE declares that he has no competing interests.

Assistant Professor of Medicine and Surgery

Section of Vascular Medicine, Department of Surgery

Sidney Kimmel Medical College at Thomas Jefferson University

Thomas Jefferson University Hospitals

Philadelphia

PA

利益冲突披露
GO declares that he has no competing interests.

Dr Geno Merli, Dr Taki Galanis, Dr Luis Eraso, and Dr Geoffrey Ouma would like to gratefully acknowledge Dr Richard White and Dr Windsor Ting, the previous contributors to this monograph. RW declares participation in numerous multicentered clinical trials sponsored by companies: Agenix, Boehringer-Ingleheim, Amgen, Bayer, Bristol-Meyer-Squibb, Novartis, Hemosense. WT declares that he has no competing interests.

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Associate Professor of Medicine

Co-Director, Thrombosis Clinic

Intermountain Medical Center

Murray

UT

利益冲突披露
SMS is co-investigator on an active trial of warfarin pharmacogenetics sponsored by Iverson Genetics, and on an active trial of the effect of active physician alerting for VTE prevention, sponsored by TWINE LLC. He has previous research contracts for trials of apixaban and rivaroxaban, and research subcontracts from the National Institute of Health (warfarin pharmacogenetics) and Canadian Institute of Health Research (use of D-dimer testing for anticoagulation cessation). SMS was a panelist on the 9th Antithrombotic guidelines panel (Diagnosis of DVT chapter) of the ACCP, and he is currently a panelist on the 10th edition (Therapy of VTE chapter).

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

利益冲突披露
BH declares that she has no competing interests.

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