急性肺栓塞合并下肢深静脉血栓形成的介入治疗  

Interventional Treatment of Acute Pulmonary Embolism Complicated with Lower Extremity Deep Venous Thrombosis

作　　者：张庆桥[1] 祖茂衡[1] 徐浩[1] 顾玉明[1] 李国均[1] 魏宁[1] 许伟[1] 崔艳峰[1] 刘洪涛[1] 王文亮[1] 

机构地区：[1]徐州医学院附属医院介入放射科,221002

出　　处：《临床放射学杂志》2009年第6期855-857,共3页Journal of Clinical Radiology

基　　金：江苏省"青蓝工程"项目(苏教师(2007)2号)

摘　　要：目的评价急性肺栓塞(acute pulmonary embolism,APE)合并下肢深静脉血栓形成(DVT)的介入治疗效果。资料与方法17例APE合并下肢DVT患者,采用下腔静脉滤器置入、猪尾导管碎栓、经导管尿激酶溶栓及抗凝治疗。结果所有患者临床症状均明显缓解。经导管尿激酶溶栓时间为5～18天,平均(9.4±5.3)天。肺动脉血栓完全溶解16例,部分溶解1例;下肢DVT完全溶解14例,部分溶解3例。溶栓治疗结束时,下腔静脉滤器取出14例,永久性留置3例。血尿2例,无其他并发症。10例随访2～18个月,无PE及下肢DVT复发。结论介入治疗APE合并下肢DVT是一种安全、有效的方法。Objective To evaluate the efficacy of interventional therapy for acute pulmonary embolism complicated with lower extremity deep venous thrombosis （DVT）. Materials and Methods 17 patients with acute pulmonary embolism complicated with lower extremity DVT underwent implantation of vena cava filters, thrombus fragmentation using pig-tail catheter, catheter-directed urokinase thrombolysis, and anticoagulation. Results Improvement in clinical symptoms was achieved in all cases. The retaining time of catheter-directed thrombolysis was 5 - 18 days, mean （9.4 ± 5.3 ） days. Complete or partial thrombus removal of pulmonary artery was accomplished in 16 cases and 1 case, respectively. Complete or partial thrombus removal of lower extremity deep veins was accomplished in 14 and 3 cases, respectively. The inserted vena cava filters were retrieved and left in the inferior vena cava for permanent use in 14 and 3 cases, respectively. Except for hematuria in 2 cases, there were no other complications. During the following-up of 2 - 18 months in 10 patients, no relapse was found. Conclusion Interventional treatment of acute pulmonary embolism complicated with lower extremity DVT is a safe and effective method.

关 键 词：放射学 介入性 肺栓塞 深静脉血栓形成 下肢 

分 类 号：R563.5[医药卫生—呼吸系统] R543.6[医药卫生—内科学]