下腔静脉滤器联合顺行置管溶栓在下肢急性深静脉血栓形成中的疗效分析  

Clinical Analysis of Inferior Vena Cava Filter Combined With Antegrade Catheter Thrombolysis For Acute Lower Extremity Deep Venous Thrombosis(LEDVT)

作　　者：孙晓磊 王伟明 张雷 何虎强 王寓平 袁罡 侯青春 徐凯强 曾宏 何延政 刘勇 

机构地区：[1]西南医科大学附属医院血管外科,四川泸州646000

出　　处：《四川医学》2016年第9期1030-1033,共4页Sichuan Medical Journal

摘　　要：目的评估下腔静脉滤器置入联合顺行置管溶栓对下肢急性深静脉血栓形成(lower extremity deep venous thrombosis,LEDVT)的临床治疗效果。方法回顾总结2013年4月至2015年11月我科87例(87条患肢)住院患者的临床资料,分析非手术治疗组(外周抗凝溶栓组)及手术治疗组(顺行置管溶栓组)患者的肢体消肿率、血栓溶解情况及静脉通畅改善度等指标。结果非手术治疗组53例,溶栓前后大腿、小腿周径差(cm)分别为(7.82±1.96)vs.(3.02±1.05)、(4.25±0.87)vs.(2.13±0.95);而手术治疗组34例,溶栓前后大腿、小腿周径差(cm)分别为(7.96±2.03)vs.(1.85±0.71)、(4.37±0.65)vs.(1.43±0.32);手术治疗组围手术期的肢体消肿率、血栓溶解情况及静脉通畅改善度明显比非手术治疗组更明显,差异有统计学意义(P<0.05)。结论下腔静脉滤器置入联合顺行置管溶栓对急性下肢深静脉血栓形成的近期疗效明显,然而其远期效果尚需进一步得到证实。Objective To evaluate the clinical effect of inferior vena cava filter placement combined with antegrade cathe-ter thrombolysis for acute lower extremity deep venous thrombosis（ LEDVT） . Methods 87 cases of hospitalized patients with their clinical data（87 limbs）in the department of vascular surgery of affiliated hospital of Southwest China Medical University between April 2013 to November 2015 were retrospectively summarized. Limb detumescence rate,thrombolysis,venous patency improvement index and other indicators of patients in non-operative treatment group （ peripheral anticoagulant thrombolytic group ） and operative treatment group（ antegrade catheter thrombolytic group） were analyzed. Results As for 53 cases in non-operative treatment group, perimeter difference（cm）of thigh before versus after thrombolytic therapy was（7. 82 ± 1. 96）vs. （3. 02 ± 1. 05）and perimeter differ-ence（cm）of calf before versus after thrombolytic therapy was（4. 25 ± 0. 87）vs. （2. 13 ± 0. 95）. As for 34 cases in surgery treatment group,perimeter difference（cm）of thigh before versus after thrombolytic therapy was（7. 96 ± 2. 03）vs. （1. 85 ± 0. 71）and perimeter difference of calf before versus after thrombolytic therapy was（4. 37 ± 0. 65）vs. （1. 43 ± 0. 32）. Limb detumescence rate,thromboly-sis and venous patency improvement index in perioperative period of operative treatment group was superior to non-operative treat-ment group,the difference being statistically significant（P〈0. 05）. Conclusion Inferior vena cava filter placement combined with antegrade catheter thrombolysis for acute lower extremity deep venous thrombosis has obvious short-term curative effect. However,its long-term effect needs to be further confirmed.

关 键 词：下腔静脉滤器 下肢急性深静脉血栓形成 置管溶栓 

分 类 号：R654.4[医药卫生—外科学]