导管接触性溶栓治疗急性下肢深静脉血栓形成中D-二聚体变化曲线及临床意义  

D-dimmer variation curve in catheter-directed thrombolysis and clinical significance

作　　者：李鲁滨[1] 车海杰[1] 宋富波[1] 张居文[1] 杨牟[1] 

机构地区：[1]青岛大学附属烟台毓璜顶医院血管外科,烟台264000

出　　处：《中华实验外科杂志》2016年第10期2384-2385,共2页Chinese Journal of Experimental Surgery

基　　金：山东省科技发展计划项目（2014GGA06057）

摘　　要：目的 探讨溶栓过程中D-二聚体变化曲线与静脉通畅率之间的关系.方法 施行导管接触性溶栓技术治疗急性下肢深静脉血栓患者136例,通过监测术前及术后5d之内的患者外周血中D-二聚体数值变化,应用超声或造影检查计算静脉通畅率,分析D-二聚体变化趋势与静脉通畅率之间有无相关性.结果 136例手术均成功,术前静脉通畅评分（8.3±1.9）分,术后（2.9±2.1）分,两者差异有统计学意义（P＜0.05）.溶栓后通畅率为（67.2±12.8）％,静脉通畅率与d1、d2、d3的D-二聚体百分比变化差异有统计学意义（P＜0.05）,静脉通畅率与d4、d5的D-二聚体百分比变化差异无统计学意义（P＞0.05）.结论 CDT治疗后第3天出现D-二聚体百分比的下降变化,D-二聚体百分比变化有助于评估溶栓效果.Objective To study the relationship between D-dimmer variation curve and venous patency in catheter-directed thrombolysis for lower extremities deep venous thrombosis.Methods 136 cases diagnosed as having lower extremities deep venous thrombosis were given catheter-directed thrombolysis in our department from January 2014 to March 2016.The D-dimmer value was regularly detected every day and venous patency was examined by ultrasonography in D1,D3 and digital subtraction angiography in D5.Then we analyzed the relationship between D-dimmer variation curve and venous patency.Results The operations in 136 cases were successful completely.Preoperative venous patency score was （8.3 ± 1.9） points,and the postoperative one was （2.9 ± 2.1） points.There was statistically significant difference between them （P 〈0.05）.The patency rate after the thrombolysis was （67.2 ± 12.8）%,and there were significant difference both venous patency and D-dimmer percentage variation in D1,D2,D3.And There were no significant difference both venous patency and D-dimmer percentage variation in D4,D5 （P 〉0.05）.Conclusion The decline in the D-dimmer percentage variation appeared on the third day in catheter-directed thrombolysis.D-dimmer percentage variation may be initially used as a monitoring indicator to assess the result of thrombolysis.

关 键 词：深静脉血栓形成 导管接触性溶栓 D-二聚体 

分 类 号：R543.6[医药卫生—心血管疾病]