检索规则说明:AND代表“并且”;OR代表“或者”;NOT代表“不包含”;(注意必须大写,运算符两边需空一格)
检 索 范 例 :范例一: (K=图书馆学 OR K=情报学) AND A=范并思 范例二:J=计算机应用与软件 AND (U=C++ OR U=Basic) NOT M=Visual
作 者:李长海[1] 张希全[1] 朱伟[1] 董戈[1] 张清[1] 郭锋[1]
机构地区:[1]中国人民解放军第一四八医院介入血管科,山东淄博255300
出 处:《中国普通外科杂志》2013年第6期705-709,共5页China Journal of General Surgery
摘 要:目的:探讨混合型下肢深静脉血栓(LEDVT)综合介入治疗的并发症及治疗对策。方法:回顾性分析7年间采用综合介入治疗的488例急性或亚急性混合型DVT患者的临床资料。所有患者先行下腔静脉滤器植入,再行机械性血栓碎吸、导管溶栓、抗凝等治疗;如合并症状性肺栓塞,则行肺动脉导管溶栓治疗;如合并髂静脉狭窄或闭塞同时行球囊扩张血管成形术(PTA)或支架植入治疗。结果:症状性肺栓塞发生率为7.58%(37/488),2例(2/37)抢救无效死亡。综合介入治疗中血管损伤发生率为9.22%(45/488),滤器拦截大块血栓的发生率为16.60%(81/488)。术后抗凝过程中发生异常出血率5.53%(27/488),2例患者因脑出血死亡。451例患者获随访4-94(平均41)个月,血栓后综合征(PTS)发生率11.53%(52/451);PTA后出现静脉再堵塞发生率为40.19%(43/107);支架植入后静脉再堵塞发生率为6.6%(7/106)。结论:综合介入疗法治疗混合型下LEDVT有一定的并发症发生率,应采取各种措施加以预防。Objective: To investigate the complications of integrated interventional treatment for mixed type of lower extremity deep vein thrombosis (LEDVT) and their management. Methods: The clinical data of 488 patients with acute or subacute mixed type LEDVT treared during 7 years were retrospectively analyzed. All patients underwent inferior vena cava filter placement, and subsequently underwent mechanical thrombus fragmentation and aspiration, catheter-directed thrombolysis and anticoagulant therapy. Intrapulmonary catheter-directed thrombolysis was performed in patients with symptomatic pulmonary embolism (PE), and balloon dilation angioplasty (percutaneous transluminal angioplasty, PTA) or post-PTA stent insertion was performed in patients with iliac vein stenosis or occlusion. Results: The incidence of symptomatic PE was 7.58% (37/488), and 2 of the PE patients (2/37) died in spite of aggressive salvage attempts, q'he incidence of vascular injury and large thrombus trapped by the filter during the integrated interventional treatment was 9.22% (45/488) and 16.60% (81/488), respectively. The incidence of abnormal bleeding during postoperative anticoagulation was 5.53% (27/488), and 2 of these patients died due to intracerebral hemorrhage. Four hundred and fifty-one patients were followed up for 4 to 94 months with average period of 41 months, during which time, the incidence of post-thrombotic syndrome (PTS) was 11.53% (52/451), and the incidence of post-PTA restenosis and reocclusion after stent placement was 40.19% (43/107) and 6.6% (7/106), respectively. Conclusion: Integrated interventional treatment for mixed type of LEDVT carries a certain risk of complications, so several preventive measures should be taken.
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在载入数据...
正在链接到云南高校图书馆文献保障联盟下载...
云南高校图书馆联盟文献共享服务平台 版权所有©
您的IP:216.73.216.222