下腔静脉滤器置入联合导管接触性溶栓治疗急性下肢深静脉血栓的临床分析  

Clinical analysis of the treatment of acute lower extremity deep venous thrombosis by using inferior vena cava filter placement and catheter directed thrombolysis

作　　者：王福安[1] 王立富[1] 王书祥[1] 孙陵[1] 吕朋华[1] 黄文诺[1] 耿素萍[1] 蔡明玉[1] 

机构地区：[1]江苏省苏北人民医院介入科,江苏扬州225001

出　　处：《实用临床医药杂志》2011年第15期25-27,共3页Journal of Clinical Medicine in Practice

摘　　要：目的评价下腔静脉滤器置入联合导管接触性溶栓治疗急性下肢深静脉血栓(DVT)的临床疗效。方法回顾性分析2008年2月～2009年10月在本院介入科行下腔静脉滤器置入联合导管接触性溶栓(CDT)治疗的15例急性DVT患者资料。所有患者均在DSA监视下置入下腔静脉滤器,再行导管接触性溶栓,术中将溶栓导管头端插入静脉血栓内部,再经溶栓导管用微泵持续注入尿激酶溶栓。治疗前及末次随访时分别测量并计算出患侧与健侧大、小腿平均周径差,采用配对t检验进行统计分析。出院后继续随访了解患者病情变化。结果所有患者治疗后下肢肿胀均显著改善,治疗前及末次随访时患侧与健侧大、小腿平均周径差有显著差异(P<0.05)。治疗过程中及治疗后随访未出现严重并发症。结论下腔静脉滤器置入联合导管接触性溶栓治疗急性下肢DVT是一种安全有效的治疗方法。Objective To evaluate the clinical efficacy of inferior vena cava filter placement combined with the catheter directed thrombolysis for acute lower extremity deep vein thrombosis（DVT）.Methods A retrospective analysis was made which was about 15 patients with acute DVT from February 2008 to October 2009 who were under the treatment of vena cava filter placement contact the United catheter thrombolysis（CDT） in our hospital treated patient information.All inferior vena cava filters were placed under surveillance DSA,and then contact catheter directed thrombolysis was taken,in which the thrombolysis catheter tip was inserted into the internal venous thrombosis,and then the urokinase was continuously infused with a micro-pump.Before treatment and final follow-up,the circumference of both the diseased leg and the uninvolved leg were measured and the difference was calculated.The paired t-test was used for statistical analysis.Follow-up was continued after discharge to understand the patient＇s condition changes.Results After treatment,the lower limb swelling symptom in all patients was significantly released,the circumference difference between the diseased and the uninvolved leg was significantly different（P0.05）.No serious complications were observed in the followup course after treatment.Conclusion Combined inferior vena cava filter placement and catheter directed thrombolysis for acute lower limb is a safe and effective treatment.

关 键 词：下肢深静脉血栓 滤器 腔内溶栓 尿激酶 

分 类 号：R658.3[医药卫生—外科学]