Kāohi ʻana i ka pae hoʻolaha thrombus

ʻAʻohe mea kānalua i ka hoʻomohala ʻana o nā anticoagulants i hoʻolaha pololei i ka mālama ʻana i ka DVT.Hiki i ka anticoagulant therapy ke pale i ka hiki ʻana mai o ka thrombus, kaohi i ka hoʻolaha ʻana o ka thrombus, hoʻomaʻamaʻa i ka autolysis o ka thrombus a me ka recanalization o lumen, hoʻēmi i nā hōʻailona, ​​​​a hoʻemi i ka hanana a me ka make o ka pulmonary embolism.I kēia manawa, ʻo nā lāʻau anticoagulant ka nui o ka heparin, ka haʻahaʻa haʻahaʻa haʻahaʻa heparin, warfarin, rivaroxaban a me dabigatran.Loaʻa i kēlā me kēia o kēia mau lāʻau i kona mau pono a me nā pōʻino.Ke hoʻohālikelike ʻia me ka heparin unfractionated, heparin haʻahaʻa haʻahaʻa haʻahaʻa subcutaneously a i ʻole intravenously hiki ke hōʻemi nui i ka make.Ma waena o nā anticoagulants waha, hoʻohana nui ʻia ʻo warfarin ma muli o ke kumu kūʻai haʻahaʻa, ka hopena anticoagulant pololei i loko o ka pae lapaʻau kūpono (e koi ana i ka ratio standardized international ma waena o 2 a me 3).Eia nō naʻe, no ka hopena nui o ka warfarin e ka meaʻai, maʻalahi ka loaʻa ʻana o nā pilikia e like me ka lawa ʻole o ka anticoagulation a me ke koko, a pono e nānā mau i ka hana coagulation.I nā makahiki i hala iho nei, uaʻikeʻia ka nui o nā anticoagulants hou i loko o ka moena, e like me rivaroxaban, dabigatran, apixaban, a me nā mea'ē aʻe ua pololei ka hopena anticoagulant, ua ho'ēmiʻia nā pilikia o ke koko, aʻaʻole pono e nānā hou i ka hana coagulation.

I kēia manawa, manaʻo kekahi poʻe loea e hiki ke hoʻokaʻawale ʻia ka lāʻau lapaʻau i ʻelua mau ʻāpana e like me ka mahele manawa o 3 mau mahina: ʻo ka pae mua i kapa ʻia ʻo ka pae lapaʻau hana mua.Hoʻohana nui ʻia ia i loko o 3 mau mahina ma hope o ka hoʻomaka mua ʻana o ka dvt3, a ʻo ka lua o ka pae i kapa ʻia ʻo ke kaʻina pale ʻana i ka hoʻihoʻi hou ʻana, i hana ʻia i 3 mau mahina ma hope o ka pae mua o ka mālama ʻana.Ua ʻōlelo mua nā alakaʻi ʻo Accp9 i nā anticoagulants waha hou.Ma ka 10th edition o ka American College of Chest Physicians (ACCP), ʻo ka ʻokoʻa nui loa mai ka wā i hala, ʻo ia nā anticoagulants waha hou (noac), e like me nā mea paʻa Xa (rivaroxaban, fondaparinux sodium, etc.) a me nā mea inhibitor IIA ( dabigatran, etc.) i koho mua ʻia no ka mālama ʻana i ka VTE.He hopena koʻikoʻi ka lāʻau anticoagulant, hoʻemi nui i ka hoʻopiʻi koko, ʻaʻole pono e nānā hou i ka hana coagulation.Ke hoʻonui houʻia nei i nā maʻi maʻamau.Hiki i nā anticoagulants hou ke pale i ka hoʻi hou ʻana o DVT ma 80% ~ 92%.

ʻO ka palena o ka lāʻau anticoagulant wale nō, ʻoiai ke hoʻohana pinepine ʻia ka lāʻau anticoagulant e hōʻemi i ka hoʻi hou ʻana o ka thrombus a pale i ka hana venous valve, ʻaʻole hiki ke hoʻopau koke i ka thrombus.ʻAʻole ʻike ʻia ka hoʻomaʻemaʻe ponoʻī ʻana o ka thrombus i nā poʻe maʻi me ka iliofemoral vein thrombosis, a hiki i ke koena thrombus ke alakaʻi i ka pōʻino venous valve a me ke keakea ʻana o ka ʻāpana, ʻo ia ke kumu o ka nui o ka maʻi post thrombosis (PTS).Ua hōʻike ʻia kahi noiʻi ʻike e pili ana i ka hanana ʻana o ka PTS ma hope o ka mālama ʻana i ka anticoagulant DVT ma kahi o 20% ~ 50%, ʻo ka maʻi o ka maʻi venous o nā lālā haʻahaʻa he 5% ~ 10%, a he 40% ka hopena o ka venous claudication. ma hope o 5 makahiki.Ma kahi o 15% o nā maʻi i loaʻa i nā maʻi neʻe, a ua hoʻemi ʻia ka maikaʻi o ke ola o 100% o nā maʻi i nā pae like ʻole.