83例急性孤立小腿深静脉血栓溶栓抗凝的疗效分析  

Analysis on effect of thrombolysis and anticoagulation in 83 cases of acute isolated calf venous thrombosis

作　　者：吴斐[1] 王洛波 王兵[1] 丁语[1] 张帝[1] 厉建林[1] 刘俊超[1] 李攀峰[1] 

机构地区：[1]郑州大学第五附属医院血管外科,郑州450052

出　　处：《重庆医学》2016年第13期1784-1786,共3页Chongqing medicine

摘　　要：目的探讨尿激酶和利伐沙班或华法林治疗急性孤立小腿深静脉血栓（IDDVT）的临床疗效及其安全性。方法回顾性分析2014年1月至2015年1月在该院收治的首次发病的急性IDDVT患者83例，患者均进行正规持续药物抗凝治疗至少3个月。其中38例进行尿激酶溶栓联合口服华法林抗凝治疗（华法林组），45例尿激酶溶栓联合口服利伐沙班进行抗凝治疗（利伐沙班组）。主要随访观察指标为7、14、21、90d后小腿深静脉的静脉血管通畅率、出血率及血栓栓塞的复发率。结果两组患者随访3个月总治疗效果编辑部，差异无统计学意义（X2=1．054，P〉0．05）；两组患者的出血发生率比较，差异有统计学意义（X2=4．824，P〈0．05）；两组患者的静脉血栓栓塞复发率比较，差异无统计学意义（X2=1．054，P〉0．05）。结论尿激酶加利伐沙班和尿激酶加华法林治疗急性IDDVT总的治疗效果相当，但利伐沙班比华法林能够明显降低出血的风险。Objective To investigate the clinical efficacy and safety of urokinase and rivaroxaban or warfarin in the treatment of acute isolated calf deep venous thrombosis. Methods Totally 83 cases of first onset of acute isolated calf deep venous thrombosis treated in our hospital from January 2014 to January 2015 were collected and retrospectively analyzed. All cases were given the regular sustained anticoagulation therapy for at least 3 months. Among them,38 cases underwent the urokinase thrombolysis and oral warfarin anticoagulation therapy （warfarin group） ,while other 45 cases were treated with urokinase thrombolysis combined with oral rivaroxaban anticoagulation therapy （rivaroxaban group）. The main follow-up observation ends were the patency rate of calf deep vein,bleeding rate and the recurrence rate of thromboembolism on 7,14,21,90 d. Results The total curative effect after 3-month follow up had no statistical difference between the two groups（X2 = 1. 054,P〉0.05）, the bleeding occurrence rate had statistical difference between the two groups（x2 = 4. 824, P〈0.05）, and the recurrence rate of thromboembolism had no statistical difference between the two groups（X2=1. 054,P〉0.05）. Conclusion Urokinase plus rivaroxaban or warfarin for treating acute isolated calf deep venous thrombosis has no obvious difference in the total curative effect,but rivaroxaban can reduce the bleeding risk more significantly than warfarin.

关 键 词：静脉血栓形成 尿激酶 抗凝药 静脉血管通畅率 出血率 

分 类 号：R543.6[医药卫生—心血管疾病]