深静脉血栓试卷.pptVIP

2.14. In patients with acute DVT of the leg, we suggest early ambulation over initial bed rest (Grade 2C) . （急性下肢DVT患者，建议早期下床活动优于卧床休息） 备注：如果下肢水肿及疼痛严重，则需延迟下床时间，建议下肢加压治疗。 2.9. In patients with acute proximal DVT of the leg, we suggest anti coagulant therapy alone over catheter-directed thrombolysis (CDT) (Grade 2C) . （在急性下肢近端DVT患者，建议单纯抗凝治疗优于导管溶栓） 2012 ACCP指南 3.1.5. In patients with DVT of the leg and active cancer, if the risk of bleeding is not high, we recommend extended anticoagulant therapy over 3 months of therapy (Grade 1B) , and if there is a high bleeding risk, we suggest extended anticoagulant therapy (Grade 2B) .（处于癌症活动期的下肢DVT患者，若出血风险不高，推荐延长抗凝时间（1B），优于3个月抗凝；若有出血风险，建议延长抗凝时间（2B）。 备注：所有延长抗凝治疗的患者，需定期评估是否需要抗凝（比如，每年一次。 3.3.2. In patients with DVT of the leg and cancer,we suggest LMWH over VKA therapy (Grade 2B) .In patients with DVT and cancer who are not treated with LMWH, we suggest VKA over dabigatran (利伐沙班）or rivaroxaban（达比加群） for long-term therapy (Grade 2B) . （肿瘤患者的DVT低分子肝素优于VKA，不接受LMNH者，VKA优于利伐沙班或达比加群。） 4.1. In patients with acute symptomatic DVT of the leg, we suggest the use of compression stockings (Grade 2B) .（急性期下肢DVT，建议应用弹力袜。） 备注：弹力袜需要穿2年，如果患者发展到PTS且穿弹力袜有帮助，就更加建议使用。不在于预防PTS而更介意弹力袜造成不适的患者很可能拒绝穿弹力袜。） 9.1.1. In patients with acute upper-extremity DVT (UEDVT) that involves the axillary or more proximal veins, we recommend acute treatment with parenteral nticoagulation (LMWH, fondaparinux,IV UFH, or SC UFH) over no such acute treatment (Grade 1B) .（累及到腋静脉或更近端静脉的急性上肢静脉血栓，推荐尽早应用胃肠外抗凝：低分子肝素、磺达肝葵钠、静脉或ih普通肝素）。 9.1.2. In patients with acute UEDVT that involves the axillary or more proximal veins, we suggest LMWH or fondaparinux over IV UFH (Grade 2C) and over SC UFH (Grade 2B) .(低分子肝素或磺达肝葵钠优于普通肝素） 9.2.1. In patients with acute UEDVT that involves the axillary or more proximal veins, we suggest anticoagulant therapy alone over hrombolysis(Grade 2C) .（单纯抗凝优于溶栓） 备注：如下患者更可能选择溶栓优于单纯抗凝：1、很可能从溶栓获益；2、可以应用导管溶栓（CDT）；3、更在意预防PTS（血栓后综合征）；4、不在意溶栓起始的复杂性、费用、出血风险。 9.2.2.