导管碎吸联合溶栓与单纯导管溶栓治疗急性髂股静脉血栓的对比分析  

Comparative Study of Aspiration Thrombectomy Combined with Catheter-directed Thrombolysis and Catheter-directed Thrombolysis Alone for Acute Iliofemoral Venous Thrombosis

作　　者：宋威 张庆桥 徐浩 祖茂衡 顾玉明 魏宁 肖晋昌 高志康 黄乾鑫 吕墩涛 SONG Wei;ZHANG Qing-qiao;XU Hao;ZU Mao-heng;GU Yu-ming;WEI Ning;XIAO Jin-chang;GAO Zhi-kang;HUANG Qian-xin;LV Dun-tao(Department of Interventional Radiology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221006,China)

机构地区：[1]徐州医科大学附属医院介入放射科,江苏徐州221006

出　　处：《中国医药指南》2018年第19期1-2,5,共3页Guide of China Medicine

基　　金：江苏省临床医学科技专项(BL2014030)

摘　　要：目的对比分析经导管血栓碎吸联合溶栓与单纯导管溶栓治疗急性髂股静脉血栓的安全性和疗效。方法 40例急性左髂股静脉血栓患者随机分为经导管血栓碎吸联合溶栓组(20例)和单纯导管溶栓组(20例)。联合溶栓组先用猪尾导管将髂静脉血栓搅碎后再用8F大腔导管进行抽吸,随后对股静脉血栓采用导管溶栓治疗;单纯溶栓组采用导管溶栓治疗。比较两组患者的血栓清除率、治疗时间、尿激酶剂量及并发症。结果两组患者血栓清除率差异无统计学意义(P>0.05);联合溶栓组患者治疗时间及尿激酶用量明显少于单纯溶栓组患者(P均<0.05);联合溶栓组无并发症,单纯溶栓组出现右侧腰大肌血肿1例、血尿1例。结论与单纯经导管溶栓治疗相比,经导管血栓碎吸联合溶栓治疗急性髂股静脉血栓可缩短溶栓治疗时间、减少尿激酶剂量并降低出血并发症,是一种安全、有效的治疗方法。Objective To compare the clinical safety and effectiveness between aspiration thrombectomy combined with catheter-directed thrombolysis(CDT)and CDT alone for the treatment of acute iliofemoral venous thrombosis(IFVT).Methods Forty patients with acute left IFVT were randomly divided into two groups.In the aspiration thrombectomy combined with CDT group(n=20),a 8F pigtail catheter was firstly used to crush the iliac venous thrombi and then an 8F suction catheter was used to aspirate the broken thrombi,followed by CDT for the treatment of thrombi in the femoral vein.CDT alone was performed in another group(n=20).The thrombus removal rate,treatment time,urokinase dosage and complications were compared between the two groups.Results There was no statistically significant difference in thrombus removal rate between the two groups(P>0.05).The treatment time and urokinase dosage in the aspiration thrombectomy combined with CDT group were significantly lower than those in the CDT alone group(P<0.05).There was no complication in the aspiration thrombectomy combined with CDT group,while psoas muscle hematoma and gross hematuria occurred in 1 patient,respectively,in the CDT alone group.Conclusion Compared with CDT alone,aspiration thrombectomy combined with CDT can reduce the treatment time,urokinase dosage and the rate of bleeding complications,is a safe and effective treatment for acute IFVT.

关 键 词：急性髂股静脉血栓 血栓抽吸 经导管溶栓术 

分 类 号：R543.6[医药卫生—心血管疾病]