BMJ:近端深静脉血栓形成后1年 vs 2年弹力袜治疗没有效果差异

2016-06-01 MedSci MedSci原创

该研究的目的是探讨近端深静脉血栓形成12个月后停止弹性压缩袜(ECS)的效果是否不劣于24个月后停止使用弹力袜。原始出处:G C Mol,M A van de Ree,F A Klok,et al.One versus two years of elastic compression stockings for prevention of post-thrombotic syndrome (OCT

该研究的目的是探讨近端深静脉血栓形成12个月后停止弹性压缩袜(ECS)的效果是否不劣于24个月后停止使用弹力袜。

来自荷兰的研究人员进行了一项多中心单盲的非劣效性随机对照试验。该研究在荷兰门诊八个教学医院进行,其中包括大学医学中心。

该研究的参与者为有症状后12个月并符合加压疗法的患者,超声诊断为下肢深静脉血栓形成。

干预方法为深静脉血栓形成12个月后延续或终止ECS治疗。

主要成终点是深静脉血栓的诊断后24个月的血栓形成后综合征的发生,由标准化Villalta规模进行评估,通过意向治疗进行分析。预定的非劣效性边际为10%。主要的次要结果是生活质量(VEINES-QOL/Sym)。

共有518例符合ECS和深静脉血栓形成诊断后1年时无血栓后综合征的患者随机接受停止或继续一年ECS治疗。在停止-ECS治疗组中,256例患者中的51例患者发生血栓后综合征,发生率为19.9%(95%置信区间为16%至24%)。在继续ECS治疗组中,262例患者中的34例患者发生血栓后综合征(发生率13.0%,9.9%至17%),其中85%的患者在研究期间每周使用ECS六,七天,绝对差异为6.9%(95%置信区间上限12.3%)。由于95%置信区间的上限超过预先设定的10%,非劣效性没有达到。通过继续ECS预防血栓后综合征的需要治疗的人数为14(95%置信区间下限8)。生活质量在两组患者中没有差异。

在这项非劣效性试验中,近端深静脉血栓形成患者一年后停止ECS,似乎没有不劣继续ECS治疗两年的患者。


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    2017-01-25 fusion
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    2017-03-10 xue8602
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    2017-04-10 gaoxiaoe
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    2016-06-03 hittouch