下腔静脉滤器联合导管溶栓治疗急性下肢深静脉血栓的疗效观察  

Efficacy of inferior vena cava filter combined with catheter thrombolysis in treatment of acute lower extremity deep venous thrombosis

作　　者：王慧勇[1] 陆东风[1] 王涛[1] 何志裕[1] 陈爱兰[1] 区碧如[1] 卜彤[1] 曾昭华[1] 

机构地区：[1]广州医科大学附属第一医院心内科,广州510100

出　　处：《岭南心血管病杂志》2016年第3期255-257,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨下腔静脉滤器联合导管溶栓治疗急性下肢深静脉血栓的疗效和临床应用。方法入选2013年2月至2015年8月广州医科大学附属第一医院连续收治的17例下肢深静脉血栓患者,其中混合型血栓15例,中央型2例;16例血栓位于左侧深静脉,1例血栓位于右侧深静脉。所有患者均经健侧股静脉插管置入滤器后,将溶栓导管置入患侧下肢静脉进行尿激酶溶栓,期间定期复查下肢深静脉造影及下肢静脉超声。结果所有患者均一次性成功置入OptEase下腔静脉滤器并成功进行尿激酶溶栓治疗,患者临床症状在溶栓5～10 d后均明显改善及消失,其中7例溶栓后下肢静脉造影左髂总静脉狭窄大于90%;5例经球囊扩张后残余狭窄小于40%;2例球囊扩张后残余狭窄大于50%,并行支架置入术,术后残余狭窄小于20%。结论下腔静脉滤器联合导管溶栓治疗急性下肢深静脉血栓安全、直接、有效,但长期疗效有待于进一步观察。Objectives To explore the efficacy and clinical application of inferior vena cava filter combined with catheter thrombolysis in treatment of acute lower extremity deep venous thrombosis. Methods Totally 17 patients with lower extremity deep venous thrombosis were sequently selected from February 2013 to August 2015 in The First Affiliated Hospital of Guangzhou Medical University, including 15 cases of mixed type, 2 cases of central type ; 16 cases of left-sided, 1 case of fight-sided. Thrombolysis catheter was implanted into the lower extremity deep venous to conduct urokinase thrombolysis after inferior vena cava filter was placed via the healthy-side venous. Angiography and ultrasound were used in the regular follow-up. Results OptEase was successfully implanted into the inferior vena cava of all the patients. The clinical symptoms improved and disappeared in 5-10 days after thrombolysis. The stenosis of the left common iliac vein was more than 90% in seven patients. The residual stenosis was less than 40% in 5 cases and more than 50% in two cases after balloon dilatation. Left common iliac vein stenting was performed in the two patients and the residual stenosis was less than 20% after surgery. Conclusions Combination of inferior vena cava filter with catheter thrombolysis in the treatment of acute lower extremity deep venous thrombosis is safe, direct and effective, but the long-term effect needs further observation.

关 键 词：下肢静脉血栓 滤器 导管 溶栓 

分 类 号：R543.6[医药卫生—心血管疾病]