下肢深静脉血栓形成腔内治疗的中远期疗效  

Mid- and long-term result of endovascular therapy for lower extremity deep venous thrombosis

作　　者：张希全 王义平[2] 朱亮[2] 潘晶晶[2] 郝斌 任可伟 

机构地区：[1]解放军第一四八医院介入血管科,山东省淄博255300 [2]山东潍坊医学院医学影像系

出　　处：《中华普通外科杂志》2014年第4期265-268,共4页Chinese Journal of General Surgery

摘　　要：目的总结机械性血栓抽吸或配合球囊取栓与血管成形术及置管溶栓治疗下肢深静脉血栓形成（lower extremity deep venous thrombosis，LEDVT）的中、远期疗效。方法回顾性分析解放军第一四八医院2000年1月至2010年6月收治的1068例LEDVT患者的临床资料。单纯介入取栓271例，介入取栓加动脉留置导管溶栓537例，介入取栓加足背静脉顺流溶栓260例；492例合并髂静脉严重狭窄或闭塞行血管成形治疗。结果l068例术后均随访36个月，水肿、色素沉着和慢性溃疡发生率10．26％、7．28％和1．55％；通畅无反流、通畅有反流、残余附壁血栓及闭塞率为84．25％、8．95％、4．3％、2．5％；胭静脉通畅率、残余血栓及闭塞率为93．32％、5．49％、1．19％。髂静脉支架植入36个月通畅率92．28％。结论LEDVT腔内治疗中、远期疗效显著，能最大程度保护静脉瓣膜功能，显著降低血栓后遗症发生率。Objective To evaluate the mid-term and long-term result of mechanical aspiration thrombectomy or combined with balloon thrombectomy, venoplasty and catheter-directed thrombolysis therapy for lower extremity deep venous thrombosis. Methods Clinical data of 1 068 admitted patients were analysed retrospectively from January 2000 to June 2010. Among these patients, 271 cases were treated by thrombeetomy only, 537 cases received thrombectomy with arterial catheter-directed thrombolysis, 260 cases were treated by thrombectomy with dorsalis pedis vein thrombolysis, 492 patients with stenosis or obstruction of iliae vein underwent venoplasty treatment. Results After 36 month follow-up edema, pigmentation and chronic ulcers were 10. 26%, 7. 28%, 1.55% respectively. The patency without reflux, patency with reflux, residual thrombus, occlusion rate of the iliofemoral vein were 84.25%, 8.95%, 4. 3%, 2. 5% respectively; The patency, residual thrombus and occlusion rate of popliteal vein were 93.32%, 5.49%, 1.19%. Iliac vein stent patency rate was 92. 28%. Conclusions Endovaseular treatment for lower extremity deep venous thrombosis was a reasonable therapy with a satisfactory mid-term and long-term result, protecting venous valve function and reducing the morbidity of post-thrombotic syndrome.

关 键 词：静脉血栓形成 血栓溶解疗法 支架 机械性血栓抽吸 

分 类 号：R654.4[医药卫生—外科学]