抗凝溶栓治疗左下肢深静脉血栓形成患者的多中心观察  

Mniticentre clinical observation of anticoagniation and thrombolysis for the deep venous thrombosis

作　　者：王海涛[1] 姜维良[1] 张英男[1] 孙占峰[1] 孙庆峰[1] 马军[1] 

机构地区：[1]哈尔滨医科大学附属第二医院血管外科,150086

出　　处：《中华医学杂志》2009年第45期3181-3185,共5页National Medical Journal of China

摘　　要：目的多中心观察不同抗凝溶栓治疗对深静脉血栓形成（DVT）的疗效和安全度。方法将临床确诊的DVT患者随机分为不同治疗组，A组用巴曲酶，B组用低分子肝素，C组用巴曲酶与低分子肝素合用，D组用尿激酶与低分子肝素合用。定期观察患肢肿胀消退情况、凝血象的变化，以及副作用发生的频率及程度，记录相关数据。所得数据进行统计学处理和比较。结果各组治疗措施（与右侧比）都能减轻患侧肢体的肿胀程度（P〈0．05）。巴曲酶与低分子肝素合用时的作用优于其他治疗方式（P〈0．05），尤其适用于发病时间长而且疗程较长的病例。巴曲酶可明显降低血纤维蛋白原的浓度（P〈0．05），而对其他凝血指标无明显影响（P〉0．05）。单用巴曲酶经患肢微量泵入的给药方式疗效优于经外周静脉的给药方式，而且临安全度较高。结论降纤合并抗凝治疗下肢深静脉血栓形成（DVT）的效果明确，尤其适用于发病时间长而且疗程较长的病例，患肢微量泵入方式效果好，安全度较高。Objective Muhicentre clinical observation for therapeutic efficacy and clinical safety of anticoagulation and thrombolysis in deep venous thrombosis （DVT）. Methods 127 patients with DVT in left leg were randomly divided into four groups. Group A： treated with batroxobin. Group B： use Low Molecular Weight Heparin（LMWH）. Group C： batroxobin and LMWH. Group D： urokinase and LMWH. Observing the perimeter of thigh and calf periodically, monitoring coagulation function, registering the frequency and degree of the complication. Results All the treatments in four groups can relieve the swell level of the affected legs（P 〈0.05）. We got the best efficacy when we use batroxobin together with LMWH （P 〈 0.05 ）, especially in treating the patients with a long course of treatment. Batroxobin can obviously reduce the level of blood FBG （ P 〈 0. 05 ） , and have no significant effect with other index of coagulation function （P 〉 0. 05 ） . Inject ing batroxobin into affected legs with the micro pump got a better efficacy and much safer than intravenously guttae from peripheral vein. Conclusion Treating DVT with batroxobin got a definite efficacy, especially in cases with a long course of treatment; micro pumping can give a better effect and a high safty.

关 键 词：静脉血栓形成 抗凝药 血栓溶解疗法 

分 类 号：R543[医药卫生—心血管疾病]