Zusammenfassung
44 Patienten mit einer phlebographisch diagnostizierten, höchstens 5 Tage alten Thrombose der tiefen Unterschenkelvenen wurden mit Streptokinase behandelt. Gleichzeitig wurden außerdem orale Antikoagulantien eingesetzt. Eine vollständige Thrombolyse wurde in 6, und eine partielle Thrombolyse in 25 Fällen erreicht. Proximale Thromben wurden besser lysiert als distale. Die Auflösung zeigte keine Korrelation mit dem Alter der Thromben. Bei 8 Patienten manifestierten sich Urtikaria und anaphylaktische Reaktionen, die die Einstellung der Therapie erforderten. In 8 Fällen kam es zu hämorrhagischen Komplikationen, die jedoch durch Absetzen der Streptokinase beseitigt werden konnten. Die Kombination von Streptokinase mit oralen Antikoagulantien verkürzt die Therapiedauer, ohne jedoch das Risiko zu erhöhen; die lytische Wirksamkeit entspricht derjenigen der früheren Studien. Streptokinase wird für die Behandlung von proximalen Thrombosen der tiefen Venen empfohlen. Sie bietet eine Möglichkeit zum Schutz vor der Entwicklung eines postthrombotischen Syndroms. Das Auftreten von verschiedenen Komplikationen sollte jedoch beachtet werden.
Summary
Fourty-four patients with deep venous thrombosis of the leg diagnosed by phlebography and not more than five days old were treated with streptokinase. Oral anticoagulant therapy was started at the same time. Complete lysis of thrombi was obtained in 6 cases and partial one in 25 cases. Lysis of proximal thrombi was better than that of distal ones. The age of the thrombi had no effect on the lysis. Urticaria and anaphylactic reactions occurred in 8 patients and treatment was discontinued. Haemorrhagic complications were present in 8 cases but remission was obtained by discontinuing streptokinase infusion. Commencing oral anticoagulant therapy simultaneously with streptokinase reduces duration of treatment without increasing the risks and the results of lysis are equally good as with earlier studies. The use of streptokinase is recommended in the treatment of proximal deep venous thrombosis. This treatment offers a possibility of preventing a postthrombotic syndrome. The frequency of various complications should however be borne in mind.
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Järvinen, P., Aromaa, U., Roiha, M. et al. Streptokinase and concomitant oral anticoagulants in the treatment of deep venous thrombosis. Klin Wochenschr 56, 801–804 (1978). https://doi.org/10.1007/BF01489713
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DOI: https://doi.org/10.1007/BF01489713