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Prevention et traitement du syndrome post-thrombotique

机译：预防和加工治疗后综合征

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Post-thrombotic syndrome: Post-thrombotic syndrome (PT5) includes all the clinical manifestations of venous insufficiency occurring after a deep vein thrombosis (DVT) of the lower limbs. PT5 would affect 30% of the patients with DVT, especially proximal DVT. Risk factors for PTS include age > 75 years, obesity, history of venous thrombosis, proximal common femoral extension, iliac or even vena cava thrombosis, multiple-segment thrombosis, persistent pain in the limb one month after DVT and insufficient anticoagulant therapy. The quality of anticoagulation, introduced early enough, at an effective dose and maintained long enough, strongly influences the risk of developing PTS. Several retrospective studies suggest that direct oral anticoagulants may be more effective in preventing PTS than VKAs. The use of elastic compression for the prevention of PTS is debated, but current evidence supports compression for the prophylaxis of PTS, at least in symptomatic patients. Pharmaco-mechanical catheter thrombolysis in the acute stage of DVT is reserved for femoroiliac DVT, which progresses negatively despite well-conducted anticoagulant therapy or is accompanied at the outset by signs of severity. The hemorrhagic risk must be integrated and the method reserved for subjects ≤ 65 years old. The Villalta score and CEAP classification quantify the intensity of PTS. The rules of venous hygiene and elastic compression are recommended when the SPT is installed. Phlebotonics are only symptomatic as a short course therapy. Venous recanalization in the chronic stage of thrombosis remains an exceptional indication. Its effectiveness is at the clinical evaluation stage.
机译：血栓形成后综合征：后血栓形成综合征（PT5）包括下肢深静脉血栓形成（DVT）后发生的所有静脉功能不全的临床表现。 PT5会影响30％的DVT患者，尤其是近端DVT。 PT的危险因素包括年龄> 75岁，肥胖，静脉血栓形成史，近端共同的股骨扩展，iLiac甚至静脉腔cava血栓形成，多段性血栓形成，DVT后一个月的肢体持续疼痛以及不足的抗凝治疗。抗凝的质量早早引入了有效的剂量并维持足够长的时间，强烈影响了患PTS的风险。一些回顾性研究表明，直接口服抗凝剂可能比VKA更有效地预防PT。辩论了使用弹性压缩来预防PTS，但目前的证据至少在有症状的患者中支持了PTS预防的压缩。 DVT急性阶段的药物机械导管溶栓是为股骨DVT保留的，尽管抗凝治疗良好，但股骨DVT仍会进行负面状态，或者在始于严重程度的迹象中伴随着。必须整合出血风险，并保留用于≤65岁的受试者。 Villalta评分和CEAP分类量化了PT的强度。安装SPT时，建议使用静脉卫生和弹性压缩规则。静脉血化物仅作为短课程疗法的症状。在血栓形成的慢性阶段中，静脉再续新化仍然是一个特殊的迹象。它的有效性是在临床评估阶段。

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