小腿肌肉静脉血栓的诊断与治疗

Diagnosis and treatment of calf muscle venous thrombosis

小腿肌肉静脉是最常发生深静脉血栓（DVT）的部位，其可单独发生血栓或伴有下肢近端DVT，单独发生于小腿肌肉静脉的血栓约占小腿DVT的41％-63％。但小腿肌肉静脉血栓（CMvT）的临床意义，在静脉血栓栓塞症（VTE）领域中仍是最具有争议的问题。CMVT如未得到适当的处理，血栓会向近端静脉发展，甚至导致肺栓塞（PE）。多普勒超声血管检查对CMVT诊断有较高的敏感性和特异性。推荐对静脉血栓形成有高危因素的病人，使用抗凝治疗。但目前的临床研究结果存在很大差异和争议，在该病的诊断、预防和治疗方面，未能形成广泛的共识和指南。

Calf muscle veins have been demonstrated to be one of the most frequent areas that develop deep venous thrombosis （DVT）, both as an isolated finding and in combination with proximal DVT. Iso｜ated calf muscle venous thrombosis （CMVT） can range from 41% to 63% of DVT that is isolated to the calf region. However, clinical implication of CMVT is still of the most debated issues in the field of venous thromboembolism （VTE）. When left untreated, a proportion tend to propagate proximally and may lead to pulmonary embolism （PE）. Imaging with duplex venous scanning （DVS） is fairly sensitive and specific in the diagnosis of CMVT. Anticoagulation therapy are recommended for the cases with high risk of VTE. Multiple studies for CMVT have variable results, so there is insufficient data to support the diagnosis and treatment of CMVT.