药物机械碎栓和导管接触性溶栓对下肢深静脉血栓患者股静脉瓣膜功能影响的病例对照研究  

Vein valve function following pharmacomechanical thrombectomy versus simple catheter-directed thrombolysis for lower extremity deep vein thrombosis:A case control study

作　　者：程章波[1] 丁杭[1] 任飞[1] 蓝永荣 李春平[1] 雷云宏[1] 韩涛[1] CHENG Zhangbo;DING Hang;REN Fei;LAN Yongrong;LI Chunping;LEI Yunhong;HAN Tao(Department of Cardiovascular Surgery,Fujian Provincial Hospital,Fuzhou,350001,P.R.China)

机构地区：[1]福建省立医院心血管外科,福州350001

出　　处：《中国胸心血管外科临床杂志》2019年第2期148-151,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家临床重点专科建设项目

摘　　要：目的比较分析药物机械碎栓和导管接触性溶栓对于下肢深静脉血栓患者股静脉瓣膜功能的影响。方法回顾性分析2016年10月到2017年3月我科室收治的60例急性髂股静脉血栓患者的临床资料。将患者分成3组:A组, 36例,男20例、女16例,平均年龄56岁,仅行导管接触性溶栓(catheter-directed thrombolysis,CDT)治疗;B组, 15例,平均年龄55岁,男8例、女7例,行单纯药物机械碎栓(pharmacomechanical thrombectomy,PMT)治疗;C组, 9例,平均年龄56岁,男4例、女5例,行PMT联合CDT治疗。比较3组治疗前后股静脉瓣膜功能情况。结果在出院时有40.0%(24/60)的患者存在双侧下肢深静脉瓣膜的反流。有40.0%(24/60)的患者存在单侧深静脉瓣膜反流(均为患肢)。有20.0%(12/60)的患者无瓣膜反流。单纯CDT治疗组中有38.9%(14/36)的患者术后存在患肢股静脉瓣膜反流,单纯PMT治疗组中有33.3%(5/15)的患者术后存在患肢股静脉瓣膜反流,PMT联合CDT组中有55.6%(5/9)的患者术后存在患肢股静脉瓣膜反流(P=0.077),差异无统计学意义。结论 PMT相比于CDT并不增加对于深静脉瓣膜功能的损害。Objective To compare vein valve function following pharmacomechanical thrombolysis(PMT) with simple catheter-directed thrombolysis(CDT) for deep vein thrombosis. Methods We retrospectively analyzed the clinical data of sixty patients who suffered acute lower extremity deep vein thrombsis in our hospital between October2016 and March 2017. All patients underwent contralateral preprocedural duplex and bilateral postprocedure duplex to access patency and valve function. The patients were divided into three groups including a group A with catheter-directed thrombolysis(CDT) alone(36 patients with 20 males and 16 females at average age of 56 years), a group B with PMT alone(15 patients with 8 males and 7 females at average age of 55 years), and a group C with PMT combined CDT(9patients with 4 males and 5 females at average age of 56 years). The valve function was compared among the Group A,Group B and Group C. Results There were 40.0%(24/60) patients with bilateral femoral vein valve reflux, 40.0%(24/60)patients with unilateral femoral vein valve reflux(all in the treated limbs), 20%(12/60) patients had no reflux in both limbs. Of the limbs treated with CDT alone, PMT alone and PMT combined CDT, the rate of valve reflux was 38.9%(14/36), 33.3%(5/15), and 55.6%(5/9) respectively(P=0.077). Conclusion In the patients suffering acute DVT, PMT or PMT combined CDT does not hamper valve function compared with CDT alone.

关 键 词：下肢深静脉血栓 药物机械碎栓 导管接触性溶栓 静脉瓣膜功能 

分 类 号：R654.4[医药卫生—外科学]