经皮机械吸栓术治疗急性下肢深静脉血栓形成18例  

Percutaneous mechanical thrombectomy in the treatment of 18 cases of acute deep venous thrombosis of lower extremities

作　　者：王长春[1] 庄小龙 韩潞[1] WANG Chang-chun;ZHUANG Xiao-long;HAN Lu(Surgery Department, Shanghai Construction Hospital, Shanghai 200083, China)

机构地区：[1]上海建工医院外科,上海200083

出　　处：《临床医学研究与实践》2019年第7期58-60,共3页Clinical Research and Practice

摘　　要：目的探讨经皮机械吸栓术(PMT)治疗急性下肢深静脉血栓形成(DVT)的可行性、安全性、有效性。方法回顾性分析2016年10月至2018年8月我院收治的18例急性下肢DVT患者的临床资料,患者均使用机械吸栓装置给予PMT治疗。依据患者术中及术后造影情况、术后临床症状缓解情况、术后随访情况评估患者的静脉复通效果与并发症发生情况。结果 18例患者中,16例(88.89%)血栓一期Ⅲ级溶解,2例(11.11%)血栓一期Ⅱ级溶解;6例(33.33%)患肢合并髂静脉压迫综合征,均在一期行经皮腔内血管成形术+支架置入术(PTAS);术后患肢大腿周径较术前减小1.8～3.5 cm,平均(2.4±0.6)cm。18例患者均无症状性肺栓塞及大出血并发症发生,平均住院时间为(10.0±1.5)d;术后随访3～24个月,患者均无下肢色素沉着及溃疡形成等严重PTS发生。结论 PMT是治疗急性下肢DVT的有效方法,长期效果需进一步观察。Objective To explore the feasibility, safety and effectiveness of percutaneous mechanical thromboembolization(PMT) in the treatment of acute deep venous thrombosis(DVT) of lower extremities. Methods Clinical data of 18 patients with acute DVT of lower extremities admitted in our hospital from October 2016 to August 2018 were retrospectively analyzed. All patients received PMT by mechanical thrombectomy device. The venous recanalization effect and complications were evaluated according to the intraoperative and postoperative angiography, the relief of postoperative clinical symptoms, postoperative follow-up. Results Of the 18 patients, 16 cases(88.89%) had primary stage Ⅲthrombolysis, 2 cases(11.11%) had primary stage Ⅱ thrombolysis, 6 patients(33.33%) with iliac vein compression syndrome, and underwent percutaneous trans-luminal angioplasty and stenting(PTAS) in one stage. The thigh circumference of affected limbs after operation decreased by 1.8-3.5 cm than that before operation, with an average of(2.4±0.6) cm. None of the 18 patients had complications of symptomatic pulmonary embolism and massive hemorrhage, the average hospitalization time was(10.0 ±1.5) d. All patients were followed up for 3-24 months, there was no severe PTS such as pigmentation and ulcer formation in lower limbs occurred. Conclusion PMT is an effective method in the treatment of acute DVT of lower extremities, and the long-term effect need further observation.

关 键 词：急性下肢深静脉血栓形成 经皮机械吸栓术 静脉复通 

分 类 号：R543[医药卫生—心血管疾病]