评价不同灌注模式溶栓治疗急性髂股静脉血栓的疗效  

Evaluation on therapeutic effect of different infusion modes for thrombolysis in acute iliofemoral vein thrombosis

作　　者：武贝[1] 顾建平[1] 楼文胜[1] 何旭[1] 陈亮[1] 陈国平[1] 苏浩波[1] 宋进华[1] 汪涛[1] 

机构地区：[1]南京医科大学附属南京第一医院介入科,江苏南京210006

出　　处：《中国介入影像与治疗学》2011年第3期227-230,共4页Chinese Journal of Interventional Imaging and Therapy

基　　金：国家"十一五"科技支撑计划课题项目(2007BAI05B04);南京市医学科技发展基金(YKK09053)

摘　　要：目的评价采用不同灌注模式导管接触性溶栓(CDT)治疗急性髂股静脉血栓的疗效。方法对65例急性髂股静脉血栓患者进行CDT治疗,术前随机分为3组:A组:21例,采用脉冲注射;B组:22例,采用连续泵入;C组:22例,采用先脉冲注射再连续泵入。24 h内以相同剂量尿激酶连续溶栓72 h,期间采用血管造影监测血栓溶解情况,观察不同溶栓灌注模式对溶栓疗效及并发症发生率的影响。结果 A、B、C组总有效率分别为71.43%、63.64%和77.27%;肢体消肿率分别为(80.00±22.10)%、(67.50±16.40)%和(92.30±15.80)%;静脉通畅度分别为(57.80±18.70)%、(55.60±19.30)%和(70.20±19.80)%。C组溶栓总有效率、肢体消肿率和静脉通畅度均明显高于A、B两组(P均<0.01),3组并发症的发生率差异无统计学意义(P>0.05)。结论采用先脉冲注射再连续泵入的溶栓灌注模式进行CDT可作为治疗急性髂股静脉血栓患者的首选灌注方式。Objective To observe the therapeutic effect of different catheter-directed thrombolysis（CDT） infusion modes in the treatment of acute iliofemoral vein thrombosis（IFVT）.Methods Totally 65 patients with IFVT were divided into three groups randomly before operation.Group A： 21 patients received CDT with pulse-spray thrombolysis.Group B： 22 patients received CDT with continuous infusion.Group C： 22 patients received CDT with pulse-spray thrombolysis,followed by continuous infusion.Urokinase of the same dosage was administrated within 72 hours in all groups.Venography was performed during thrombolysis to observe the effect and incidence of complications.Results The total effective rate of group A,B and C was 71.43%,63.64% and 77.27% respectively.The limbs edema reduction rate was（80.00±22.10）%,（67.50±16.40）% and（92.30±15.80）%,respectively,while the rate of venous recanalization was（57.80±18.70）%,（55.60±19.30）% and（70.20±19.80）%,respectively.The total effective rate,the limbs edema reduction rate and the rate of venous recanalization of group C was significantly higher than group A and B（all P0.01）.The complications showed no significant difference among three groups（P0.05）.Conclusion The pulse-spray thrombolysis followed by continuous infusion mode may be the preferable treatment of acute IFVT.

关 键 词：血栓溶解疗法 静脉血栓形成 放射学 介入性 

分 类 号：R543[医药卫生—心血管疾病]