经颈静脉插管尿激酶溶栓治疗髂股深静脉血栓形成  

Catheter-directed urokinase thrombolytic therapy for iliofemoral deep venous thrombosis via jugular vein approach

作　　者：徐浩[1] 祖茂衡[1] 顾玉明[1] 李国均[1] 张庆桥[1] 魏宁[1] 许伟[1] 刘洪涛[1] 陈雪荣[1] 

机构地区：[1]徐州医学院附属医院介入放射科,江苏徐州221002

出　　处：《中国医学影像技术》2005年第6期953-955,共3页Chinese Journal of Medical Imaging Technology

基　　金：江苏省社会发展基金资助(BS03009)

摘　　要：目的探讨经颈静脉插管尿激酶溶栓治疗髂股深静脉血栓形成(DVT)的方法及疗效.方法47例髂股DVT患者(右侧4例,左侧43例)采用经颈静脉途径插管推注尿激酶溶栓治疗,其中13例在下腔静脉滤器置入后经导管尿激酶溶栓治疗.溶栓后对髂静脉明显狭窄者采用PTA(m=26)或PTA及支架置入治疗(n=7).结果47例患者皆溶栓导管放置成功,插管成功率为100%.溶栓治疗24 h有效率为93.62%(44/47),48 h有效率为100%,血栓明显溶解率达80.85%(38/47).47例患者随访4～17个月(平均6.9个月),症状、体征消失或明显改善者35例,部分改善者8例,复发4例.无颅内出血发生.结论经颈静脉途径行导管尿激酶溶栓治疗髂股DVT是一种可行的、安全、有效的治疗方法.Objective To investigate the method and efficacy of catheter-directed urokinase thrombolysis for iliofemoral deep venous thrombosis (DVT) via jugular vein approach. Methods Forty-seven patients with iliofemoral DVT, including right lower-extremity in 4 patients and left lower-extremity in 43 patients, underwent catheter-directed urokinase thrombolysis via jugular vein approach, among which a filter was placed in inferior vena cave (IVC) in 13 cases. After the thrombolysis, PTA alone in stenostic iliac vein was performed in 26 patients, PTA and stenting in 7 patients. Results All patients with iliofemoral DVT were catheterized via jugular vein, with 100% success rate. Symptoms alleviated in 44 ( 93.62% ) of the 47 patients in 24 hours and in all patients in 48 hours after the thrombolysis. Marked lysis was achieved in 38 ( 80.85% ) of the 47 patients. During a period of 4-17 months (means 6.9 months) following-up, disappearance and marked improvement of symptoms and signs happened in 35 patients, part improvement in 8 patients and reoccurrence in 4 patients. No intracranial hemorrhage happened. Conclusion Catheter-directed urokinase thrombolysis for iliaofemoral DVT, via jugular vein approach, is a feasible, safe and effective method.

关 键 词：静脉血栓形成 下肢 溶栓疗法 尿激酶 

分 类 号：R543.6[医药卫生—心血管疾病] R815[医药卫生—内科学]