急性中央型下肢深静脉血栓形成不同溶栓方法的比较  

Comparison of different thrombolysison in acute deep venous thrombosis

作　　者：刘彦春[1] 杨植[1] 袁秀荣[1] 高畅[1] 张立敏[1] 刘永霞[1] 

机构地区：[1]承德医学院附属医院血管外科,河北承德067000

出　　处：《山东大学学报（医学版）》2011年第11期61-63,共3页Journal of Shandong University:Health Sciences

摘　　要：目的探讨不同溶栓方法在急性中央型下肢深静脉血栓形成中的治疗效果。方法将28例急性中央型下肢深静脉血栓形成的患者随机分为两组,每组14例。对照组:下腔静脉滤器保护下经患肢浅静脉溶栓治疗;研究组:下腔静脉滤器保护下,经股静脉置管溶栓治疗。两组均进行规范化抗凝治疗,监测凝血功能。测量指标包括肢体周径差、血栓溶解程度、溶栓药物用量。结果两组健、患肢周径差值均减小,研究组患肢肿胀消退较对照组快(P<0.01)。研究组血栓完全消失5例(35.71%),与对照组比较,溶栓疗效显著(P<0.01)。研究组尿激酶用量(1.56±5.80)×106U,较对照组(3.06±8.24)×106U明显减少(P<0.01)。对照组出现肉眼血尿、滤器移位各1例,两组均未出现肺栓塞。结论下腔静脉滤器植入结合导管溶栓治疗急性中央型下肢深静脉血栓形成疗效显著,安全性高。Objective To investigate the therapeutic effect of different thrombolysison on acute deep venous thrombosis（DVT）.Methods Twenty-eight patients with acute DVT were randomly divided into the control group（n=14） and the experimental group（n=14）.After inferior vena cava filter（IVCF） placement,patients in the control group received systemic thrombolysis and anticoagulation therapy,while patients in the experimental group underwent anticoagulation therapy and catheter-directed thrombolysis.Circumferences of the limbs were measured before and after treatment.The thrombolytic level was evaluated by venography.Recent complications of interventional therapy and the occurrence of pulmonary embolism（PE） were observed. Results The differentials were both reduced in circumferences of healthy and affected lower extremities after treatment.The resolution time of swelling in affected extremities was shorter in the experimental group than in the control group（P0.01）.The thrombi completely disappeared in 5 patients（35.71%）.The resolution time of thrombi was shorter in the experimental group than in the control group（P0.01）.The mean dose of urokinase used in the experimental group was（1.56 ±5.80） ×106U,which was significantly lower than（3.06±8.24）×106U in the control group（P0.01）.In the control group,gross-hematuria w and displacement of IVCF occurred in 1 patient.PE did not occurred in either group.Conclusion IVCF placement and catheter-directed thrombolysis is a safe and effective procedure for acute DVT in the lower extremities.

关 键 词：下腔静脉滤器 深静脉血栓形成 导管溶栓 肺栓塞 静脉血栓后综合征 

分 类 号：R654.4[医药卫生—外科学]