经皮桡动脉穿刺股动脉置管溶栓治疗下肢深静脉血栓形成的探讨  

Study on thrombolytic therapy for lower extremity deep vein thrombosis with femoral artery catheter through percutaneous radial artery puncture

作　　者：郑翼德[1] 胡小艳[1] 方力[1] 樊孝文[1] 余永忠[2] 

机构地区：[1]郴州市第一人民医院血管外科血管外科,湖南郴州423000 [2]郴州市第一人民医院血管外科介入科,湖南郴州423000

出　　处：《中国现代医学杂志》2013年第30期72-75,共4页China Journal of Modern Medicine

基　　金：郴州市第一人民医院科研资助项目(No:N2010-038)

摘　　要：目的探讨经皮桡动脉穿刺股动脉置管溶栓给药治疗下肢深静脉血栓形成的特点。方法将71例单侧下肢深静脉血栓形成患者随机分成A(经皮桡动脉穿刺股动脉置管溶栓组)、B(经皮外周静脉穿刺给药溶栓组)、C(经皮股动脉穿刺置管溶栓组)、D(经皮深静脉穿刺置管溶栓组)4组,泵入尿激酶溶栓。统计并比较穿刺置管成功率、住院费,以及患肢不同时间的肿胀缓解度、深静脉通畅度评分、痛苦度评分的差异。结果穿刺置管成功率:A组88.9%(16/18),B组100.0%(19/19),C组93.8%(15/16),D组72.2%(13/18)。A组与B、C、D3组比较,无明显差异(P>0.05)。住院费:A组(9139.5±1110.1)元,B组(4902.9±872.1)元,C组(9030.7±728.1)元,D组(25229.9±1203.4)元,A组与B组、D组比较,差异明显(P<0.05)。肿胀缓解度:D组较高,A、C组次之,B组较低;静脉通畅改善度:A、C、D组效果较好,B组较差;痛苦度评分:A、B组较低,C、D组较高。结论A组不仅有较好的溶栓效果,而且在穿刺成功率、降低痛苦度和降低住院费用方面具有较大优势,是一种值得推广的溶栓方法。[ Objective ] To study the characteristics of thrombolytic therapy for lower extremity deep vein thrombosis （LDVT） with femoral artery catheter through percutaneous radial artery puncture. [ Methods ] 71 cases with unilateral LDVT were randomly divided into group A （thrombolytic therapy for LDVT with femoral artery catheter through percutaneous radial artery puncture）, group B （thrombolytic therapy for LDVT with percutaneous peripheral venous puncture）, group C （thrombolytic therapy for LDVT with femoral artery catheter through percutaneous femoral artery puncture）, group D （thrombolytic therapy for LDVT with femoral vein catheter through percutaneous femoral vein puncture）. Urokinase was injected by pump. The success rate of catheterization, the cost of hospitalization, the Limb resolution of the swelling degree, the deep vein patency score and the pain score were compared among 4 groups. [ Results ] The catheterization success rate： group A 88.9% （16/18）, group B 100.0% （19/19）, 93.8% （15/16）, group D 72.2%（13/18）. There were no significant difference between group A and B, C, D（P 〉0.05）. The cost of hospitalization： group A （9139.5±1110.1） yuan, group B （4902.9 ± 872.1） yuan, group C （9030.7±728.1） yuan, group D （25229.9±1203.4） yuan. There were significant differences among group A and group B, group D（P 〈0.05）. The limb resolution of the swelling degree： D, A, C were higher, group B were lower. The deep vein patency score： group A, C, D were lower than group B. The pain score： group A, B were lighter than group C, D. [Conclusions] Group A have not only a good thrombolytic effect, but also have greater advantages in success rate of catheterization, cost of hospitalization, limb resolution of the swelling degree, deep vein patency score and the pain score. It is worth to spread.

关 键 词：桡动脉 股动脉 深静脉血栓形成 溶栓 

分 类 号：R473.6[医药卫生—护理学]