静脉血栓栓塞症治疗的新进展

New Advances in the Treatment of Venous Thromboembolism

摘要: 静脉血栓栓塞症(venous thromboembolism, VTE)包括肺动脉血栓栓塞(pulmonary thromboemlism, PTE)和深静脉血栓形成(deep vein thrombosis, DVT)。DVT是指血液在深静脉腔内不正常凝结，阻塞静脉腔，导致静脉回流障碍，如未及时治疗，急性期可并发肺动脉血栓栓塞，慢性期可并发深静脉血栓形成后综合征(post-thrombotic syndrome, PTS)，影响正常的生活和工作能力。肺栓塞是各种栓子阻塞肺动脉或其分支为发病原因的一组疾病或临床综合征的总称，包括肺动脉栓塞、脂肪栓塞综合征、羊水栓塞、空气栓塞等。PTE是来自静脉系统或右心的血栓阻塞肺动脉或其分支所导致的以循环和呼吸功能障碍为主的临床和病理生理特征的疾病。PTE是肺栓塞中最常见的一种类型，引起肺血栓栓塞的血栓主要来源于DVT，经常是致命的并发症。PTE与DVT实质上被认为是同一疾病过程在不同阶段和不同部位的临床表现，两者发病机制上有因果关系且治疗方法相似，故DVT和PTE统称为VTE。近年来，DVT的相关研究逐渐成为热点，但关于其流行病学研究、病因及危险因素、临床分型、表现、治疗、是否需要介入治疗及治疗时长等一系列问题一直未达成一致，给临床工作者带来了很大的困扰。本文主要对近年来关于DVT的研究成果进行归纳总结，为以后DVT进一步的研究提供一定的参考价值。

Abstract: Venous thromboembolism (VTE) includes pulmonary thromboembolism (PTE) and thrombosis thrombosis (DVT). DVT refers to abnormal blood clotting in the deep vein lumen, blocking the vein lumen, resulting in venous reflux disorders, if not treated in time, acute phase may be complicated by pulmonary thromboembolism, post-thrombotic syndrome (PTS) can be thrombosis in the chron-ic phase, affecting the ability to live and work normally. Pulmonary embolism (PE) is a group of dis-eases or clinical syndromes caused by embolus blocking pulmonary artery or its branches, includ-ing PE, fat embolism syndrome, amniotic fluid embolism, air embolism, etc. PTE is a disease char-acterized by clinical and pathophysiological features of circulatory and respiratory dysfunction re-sulting from thrombus occlusion of the pulmonary artery or its branches from the venous system or the right heart. PTE is the most common type of pulmonary embolism, which is caused by DVT, often a fatal complication. PTE and DVT are essentially considered to be the clinical manifestations of the same disease process at different stages and at different sites. The pathogenesis of PTE and DVT is causally related and the treatment methods are similar. Therefore, DVT and PTE are collectively called VTE. In recent years, DVT-related research has gradually become a hot spot, however, there is no agreement on a series of questions about its epidemiology, etiology and risk factors, clinical clas-sification, manifestation, treatment, need for interventional therapy and the duration of treatment; it brings great trouble to the clinical workers. This article mainly summarizes the research results of DVT in recent years, and provides some reference value for the further study of DVT in the future.