介入导管直接溶栓与静脉溶栓并抗凝治疗下肢深静脉血栓的对比研究（英文）  

Comparative study between intervention transcatheter direct thrombolysis and vein thrombolysis plus anti-coagulation therapy for treating lower extremity deep venous thrombosis

作　　者：徐国建[1] 

机构地区：[1]广东佛山市第一人民医院血管甲状腺外科,广东佛山528000

出　　处：《心血管康复医学杂志》2015年第4期402-406,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:对比导管直接溶栓和静脉溶栓加抗凝治疗下肢深静脉血栓的临床疗效。方法:选择符合纳入标准的下肢深静脉血栓患者61人,随机分为介入直接溶栓组(30例,介入组)和静脉溶栓+抗凝组(溶栓+抗凝组,31例)。治疗4周为一疗程。结果:介入组总有效率为93.33%,显著高于溶栓+抗凝组的64.52%(χ2=4.987,P=0.032)。两组治疗前血液流变学指标差异无统计学意义(P>0.05)。与治疗前比较,治疗后介入组全血高切粘度、全血低切粘度、血浆粘度及纤维蛋白原水平均显著降低(P均<0.05);溶栓+抗凝组只有血浆粘度、纤维蛋白原水平显著降低(P均<0.05);与溶栓+抗凝组比较,治疗后介入组全血低切粘度[(12.10±2.13)mPa·s比(11.08±1.67)mPa·s]和血浆粘度[(1.85±0.13)mPa·s比(1.31±0.09)mPa·s]显著降低(P均<0.05)。治疗后介入组血管开通总有效率为90.00%,显著高于溶栓+抗凝组的61.29%,χ2=4.173,P=0.047。结论:对于急性期深静脉血栓形成并且无手术禁忌证的患者,导管直接溶栓疗效更显著,能明显改善血液流变学和提高血管开通率,可推荐为临床首选。Objective： To compare the therapeutic effect of intervention transcatheter direct thrombolysis and vein thrombolysis and anti-coagulation drugs on lower extremity deep venous thrombosis （DVT）. Methods.. A total of 61 patients with lower extremity DVT accorded with inclusion standards were selected. They were randomly divided in- to intervention transcatheter direct thrombolysis group （n= 30, intervention group） and vein thrombolysis and anti- coagulation group （n= 31, thrombolysis anti-coagulation group）. Patients were treated for four weeks as a course. Results： Total effective rate of intervention group was significantly higher than that of thrombolysis＋anti-coagula- tion group （93.33% vs. 64.52% ）, x2 =4. 987, P=0. 032. There were no significant differences in hemorheology indexes between two groups before treatment, P〈0.05. Compared with before treatment, after treatment, there were significant reductions in high shear whole blood viscosity, low shear whole blood viscosity, plasma viscosity and fibrinogen level in intervention group, P〈0.05 all; there were significant reductions in plasma viscosity and fibrinogen level in thrombolysis＋ anti-coagulation group, P〈0.05 both. After treatment, compared with thrombolysis anti-coagulation group, there were significant reductions in low shear whole blood viscosity [ （12.10±2. 13） mPa ·s vs. （11.08±1.67） mPa · s] and plasma viscosity [ （1.85±0. 13） mPa ·s vs. （1.31±0.09） mPa · s] in intervention group, P〈0.05 both. After treatment, total effective rate of vessel open up in intervention group was significantly higher than that of thrombolysis-- anti-coagulation group （ 90.00 % vs. 61.29 % ）, x2 = 4. 173, P = 0. 047. Conclusion： For patients with acute DVT and no operation contraindications, therapeutic effect of transcatheter direct thrombolysis is more significant. It can significantly improve hcmorheology and vessel open up rate, it may berecommended as the preferred in clinic.

关 键 词：导管插入术 血栓溶解疗法 静脉血栓栓塞 

分 类 号：R543.6[医药卫生—心血管疾病]