单纯导管接触性溶栓与联合药物机械碎栓治疗急性下肢深静脉血栓的对照研究  

Comparison of clinic outcomes following pharmacomechanical thrombectomy versus simple catheter-directed thrombolysis for lower extremity deep vein thrombosis

作　　者：程章波[1] 丁杭[1] 黄烽[1] 任飞[1] 蓝永荣 李春平[1] 雷云宏[1] 蔡红[1] 韩涛[1] Cheng Zhangbo, Ding hang, Huang Feng, Ren Fei, Lan Yongrong ,Li Chunping ,Lei Yunhong, Cai Hong, Han Tao(Department of cardiovascular surgery, Fujian Province-owned Hospital, Fuzhou 350001, China)

机构地区：[1]福建省立医院心血管外科,福州350001

出　　处：《血管与腔内血管外科杂志》2018年第3期197-200,227,共5页Journal of Vascular and Endovascular Surgery

基　　金：国家临床重点专科建设项目(国卫办医函【2013】544号)

摘　　要：目的比较单纯置管溶栓(CDT)与联合药物机械碎栓(PMT)治疗急性下肢深静脉血栓形成的安全性及有效性。方法回顾性分析2016年10月至2017年3月福建省立医院收治的60例急性髂股静脉血栓形成的患者的临床资料。将患者分成2组,A组36例采用CDT治疗,B组24例采用PMT或PMT联合CDT治疗。比较2组患者治疗前后健侧和患侧下肢周径差、尿激酶用量及溶栓时间、出血并发症、股静脉瓣膜返流情况及血栓后综合征发生率。结果 2组患者治疗前后的大小腿周径差的组间比较没有统计学差异。B组的尿激酶用量及溶栓时间均显著低于A组,2组差异具有统计学意义(Z=-5.906,P<0.01)。2组溶栓期间出血发生率的差异无统计学意义(χ~2=0.431,P=0.511)。A组和B组中分别有38.9%和41.7%的患者术后存在患肢股静脉瓣膜返流,差异没有统计学意义(Z=-0.098;P=0.922)。2组患者随访期间PTS发生率无统计学差异(χ~2=0.900,P=0.343)。结论对于急性髂股静脉DVT的患者,CDT和PMT都是安全有效的。PMT能缩短溶栓时间,减少溶栓药物的用量。Objective Comparison of effectiveness and safety following pharmacomechanical thrombolysis versus simple catheter-directed thrombolysis for deep vein thrombosis. Methods The clinical data of 60 patients with acute iliofemoral venous thrombosis admitted to Fujian Provincial Hospital from October 2016 to March 2017 were retrospectively analyzed. Patients were divided into 2 groups, 36 patients in group A were treated with CDT, and 24 patients in group B were treated with PMT or PMT combined with CDT. The difference in circumferential diameter of the contralateral and affected limbs, the amount of urokinase and thrombolysis time, bleeding complications, femoral venous regurgitation and post-thrombotic syndrome were compared between the two groups. Results There was no statistical difference between the two groups before and after treatment. The amount of urokinase and thrombolysis time in group B were significantly lower than those in group A, and the difference between the two groups was statistically significant（Z=-5.906, P0.01）. There was no significant difference in the incidence of bleeding between the two groups during thrombolysis（Z=0.431, P=0.511）. There were 38.9% and 41.7% of patients in group A and group B, respectively, and there was no significant difference in the femoral venous valve regurgitation（Z=-0.098, P=0.922）. There was no significant difference in the incidence of PTS between the two groups during follow-up（Z=0.900, P=0.343）. Conclusion Both CDT and PMT are safe and effective in patients with acute iliofemoral DVT. PMT can shorten the time of thrombolysis and reduce the amount of thrombolytic drugs.

关 键 词：下肢深静脉血栓 药物机械碎栓 导管接触性溶栓 血栓后综合征 

分 类 号：R543.6[医药卫生—心血管疾病]