接触性导管溶栓治疗急性左下肢深静脉血栓形成的单中心经验  

Catheter-directed thrombolysis for DVT in left lower limb:a momocenter experiment

作　　者：曹健强[1] 谭羽灿[1] 邢越[1] 罗灿华[1] CAO Jianqiang;TAN Yucan;XING Yue;LUO Canhua(Department of Vascular Surgery,The First People's Hospital of Foshan,Foshan Guangdong 528000,China)

机构地区：[1]佛山市第一人民医院血管外科

出　　处：《岭南现代临床外科》2019年第3期350-353,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的探讨采用接触性导管溶栓治疗急性左下肢深静脉血栓形成的临床疗效。方法收集我科2010年06月~2014年01月期间行导管溶栓治疗38例急性左下肢深静脉血栓形成的临床资料,所有患者均采用接触性导管溶栓治疗。比较治疗前后双下肢周径差、溶栓并发症、血栓后综合征等疗效指标。结果所有患者经溶栓治疗后痊愈或好转后出院,出院前双下肢髌骨下10cm周径差由3.74±0.94cm下降为1.85±0.76cm;双下肢髌骨上10cm周径差径差由7.31±0.91cm下降为4.35±1.28cm,经配对样本t检验,P<0.05,治疗效果显著。平均随访18±9.3个月,随访成功率100%,随访期间10例(26.3%)患者诊断为血栓后综合征。结论采用导管溶栓治疗急性下肢深静脉血栓形成的疗效确切、血栓后综合征发生率较低,是安全有效的治疗手段。Objective To investigate the feasibility and efficacy of catheter-directed thrombolysis(CDT)in treatment for deep venous thrombosis(DVT)of lower limbs.Methods The clinical data of38 patients with acute DVT from June 2010 to January 2014 in the First Peoples′ Hospital of Foshan were analyzed retrospectively.All patients were treated with CDT.Then,thrombolysis and intermittent compression therpy were performed again.Limb circumference difference between preoperative and postoperative,complications of thrombolysis and post-thrombotic syndrome(PTS) were compared between before and after treatment.Result All patients undergo thrombolysis were cured or improved.Thecircumference difference 10 cm below patella between bilateral limbs was reduced from(3.74±0.94)cm to(1.85±0.76)cm.The circumference difference 10 cm above patella between bilateral limbs was reduced from(7.31±0.91)cm to(4.35±1.28)cm.The duratioins of follow-ups for(18±9.3)months and the follow up rate was 100%.The PTS was diagnosed in 10 patients followed.Conclusion Using two catheterdirected thrombolysis combined with intermittent compression therapy has a definite curative effect on DVT of low extremities and the incidence of PTS was low.

关 键 词：导管溶栓 下肢深静脉血栓形成 COCKETT综合征 血栓后综合征 

分 类 号：R654.4[医药卫生—外科学]