Kudzivirira thrombus kupararira danho

Hapana mubvunzo kuti kugadzirwa kweanticoagulants kwakasimudzira zvakananga kurapwa kweDVT.Anticoagulant therapy inogona kudzivirira kuitika kwethrombus, inhibisa kupararira kwethrombus, kufambisa autolysis yethrombus uye recanalization ye lumen, kuderedza zviratidzo, uye kuderedza chiitiko uye kufa kwepulmonary embolism.Parizvino, anticoagulant mishonga inonyanya kusanganisira heparin, yakaderera molecular uremu heparin, warfarin, rivaroxaban uye dabigatran.Imwe neimwe yemishonga iyi ine zvayakanakira nezvayakaipira.Kana ichienzaniswa neiyo unfractionated heparin, yakaderera molecular uremu heparin subcutaneously kana intravenously inogona kuderedza zvakanyanya kufa.Pakati pemishonga yemuromo anticoagulants, warfarin inoshandiswa zvakanyanya nekuda kwemutengo wayo wakaderera, yakarurama anticoagulant effect mukati mehutano hunobudirira hwekurapa (inoda kuti chiyero chepasi rose chive pakati pe2 ne3).Nekudaro, nekuti warfarin inobatwa zvakanyanya nechikafu, zviri nyore kuve nematambudziko akadai sekusakwana anticoagulation uye kubuda ropa, uye zvinodikanwa kuti utarise coagulation basa nguva nenguva.Mumakore achangopfuura, nhamba yakawanda yemishonga mitsva yakaonekwa pamubhedha, yakadai se rivaroxaban, dabigatran, apixaban, nezvimwewo, anticoagulant effect yakarurama, matambudziko ekubuda ropa anoderedzwa, uye hapana chikonzero chekuongororazve basa rekugadzirisa.

Parizvino, dzimwe nyanzvi dzinoratidza kuti kurapwa kwemishonga kunogona kugoverwa muzvikamu zviviri maererano nenguva yekuparadzanisa kwemwedzi mitatu: danho rekutanga rinonzi danho rekutanga rinoshanda rekurapa.Inonyanya kuitwa mukati memwedzi mitatu mushure mekutanga kwedvt3, uye danho rechipiri rinonzi kutevera-up recurrence prevention stage, iyo inoitwa mwedzi mitatu mushure mekutanga kwekurapwa.Accp9 nhungamiro yakatanga kukurudzira mitsva yemuromo anticoagulants.Muchikamu chegumi cheAmerican College of Chest Physicians (ACCP) nhungamiro, musiyano mukuru kubva kare ndewekuti itsva oral anticoagulants (noac), yakadai sefactor Xa inhibitors (rivaroxaban, fondaparinux sodium, nezvimwewo) uye factor IIA inhibitors ( dabigatran, nezvimwewo) anoshandiswa sesarudzo yekutanga kurapwa kweVTE.Anticoagulant therapy ine mhedzisiro chaiyo, inoderedza zvakanyanya matambudziko ekubuda ropa, uye haidi kuongororwazve kweiyo coagulation basa.Iri kusimudzirwazve muvarwerewo zvavo.Maanticoagulants matsva anogona kazhinji kudzivirira kudzokorora kweDVT mu80% ~ 92%.

Iyo inogumira yeanticoagulant therapy chete ndeyekuti kunyangwe anticoagulant therapy inowanzoshandiswa kuderedza thrombus kudzoka uye kudzivirira venous valve basa, haigone kunyungudutsa thrombus nekukurumidza.Kuzvichenesa kwe thrombus hakuwanzo kucherechedzwa kune varwere vane iliofemoral vein thrombosis, uye yakasara thrombus inogona kutungamirira kukuvadzwa kwevharuvhu yevharuvhu uye kubuda turakiti kuvharika, izvo zvikonzero zvekuwanda kwechiitiko che post thrombosis syndrome (PTS).Chidzidzo chekucherechedza pamusoro pekuitika kwePTS mushure meDVT anticoagulant kurapwa kwakaratidza kuti chiitiko chePTS chaive chinenge 20% ~ 50%, chiitiko chechirwere chechironda chemakumbo ezasi chaiva 5% ~ 10%, uye chiitiko chevenous claudication chaiva 40% mushure memakore mashanu.Inenge 15% yevarwere vaiva nezvinetso zvekufamba, uye hupenyu hwehupenyu hwe100% yevarwere hwakaderedzwa kusvika kune zvakasiyana-siyana.