药物机械偶联治疗急性和亚急性下肢深静脉血栓形成疗效分析  

Analysis of curative effect of drug mechanical coupling therapy for acute and sub-acute deep venous thrombosis of lower extremities

作　　者：温永冰 王瑞华[2] 刘兆轩[2] 史孟杰 孟庆义[2] WEN Yong-bing;WANG Rui-hua;LIU Zhao-xuan;SHI Meng-jie;MENG Qing-yi(Graduate School, Taishan Medical University, Tai’an 271016, China;Department of Vascular Surgery, Jinan Central Hospital of Shandong University, Jinan 250013,China)

机构地区：[1]泰山医学院研究生院,山东泰安271016 [2]山东大学附属济南市中心医院血管外科,济南250013

出　　处：《中国血管外科杂志（电子版）》2019年第1期24-27,共4页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：济南市科学技术发展计划(201704134);山东省医药卫生科技发展计划(2017WSA01007)

摘　　要：目的评价AngioJet机械偶联药物清除急性和亚急性期下肢深静脉血栓形成(DVT)的临床疗效。方法回顾性分析2016年8月至2017年11月济南市中心医院血管外科应用AngioJet机械药物偶联清除的28例急性和亚急性期DVT患者资料,评价术后血栓的清除率、患肢的消肿率、术后1年静脉管腔的通畅性及血栓形成后综合征(PTS)的Villalta评分。结果手术成功率为89.29%,临床成功率为100%。血栓清除率为(81.7±18.29)%;大腿的消肿率为(72.75±19.95)%;小腿的消肿率为(51.96±16.64)%,和术前相比差异有统计学意义(P<0.05)。术中有3例患者出现窦性心动过缓,有4例患者出现胸闷及憋喘,怀疑一过性肺栓塞。无颅脑及腹膜后大出血病例;无肾功能损伤患者;无患者死亡及其他手术相关并发症。术后1年随访,Villalta评分为(2.75±2.29)分,其中3例患者有轻度PTS,1例有中度PTS,PTS的发生率为14.29%。管腔通畅患者有24例,通畅率为85.71%。结论 AngioJet机械偶联药物清除急性期、亚急性期下肢DVT的近期及中期疗效令人满意。Objective To evaluate the clinical efficacy of Angiojet mechanical coupling drugs in clearing acute and sub-acute deep venous thrombosis(DVT) of lower extremities. Methods Clinical date of 28 patients with acute and sub-acute DVT of lower extremities treated with AngioJet mechanical drugs in department of vascular surgery, Jinan Central Hospital of Shandong University from August 2016 to December 2017 was analysed retrospectively. Thrombus clearance rate, limb swelling rate, venous lumen patency one year after operation and Villalta score of post-thrombotic syndrome (PTS) were evaluated. Results The successful rate of operation was 89.29% and the clinical success rate was 100%. The thrombus clearance rate, the thigh swelling rate and the calf swelling rate was(81.7±18.29)%,(72.75 ±19.95)%,(51.96±16.64)%, respectively. The difference was statistically significant (P<0.05). During the operation, 3 patients had sinus bradycardia, 4 patients had chest tightness and wheezing and suspected transient pulmonary embolism. No craniocerebral and retroperitoneal hemorrhage occurred, no patients with renal impairment were found and no patient died and other related complications related to operation. After the follow-up of 1 year after operation, Villalta score was 2.75±2.29. 3 cases had mild PTS and 1 case had moderate PTS. The incidence of PTS was 14.29%. The patency rate was 85.71%(24 cases). Conclusion The short and mid-term effect of AngioJet mechanical coupling drug for removing DVT of lower extremities in acute and sub-acute stages is satisfactory.

关 键 词：下肢深静脉血栓形成 经皮机械取栓 置管溶栓 血栓形成后综合征 

分 类 号：R654.4[医药卫生—外科学]