两种溶栓药在亚急性下肢动脉闭塞症中的应用价值  

Clinical Value of Two Thrombolytic Drugs in Subacute Lower Extremity Arterial Occlusive Disease

作　　者：王富华 邓方方 周涛[1] 洪帆 姜胜攀 雷文峰 Wang Fuhua;Deng Fangfang;Zhou Tao;Hong Fan;Jiang Shengpan;Lei Wenfeng(Tongren Hospital Affiliated to Wuhan University,Wuhan 430070,China)

机构地区：[1]武汉大学附属同仁医院(武汉市第三医院)

出　　处：《北华大学学报（自然科学版）》2019年第4期510-514,共5页Journal of Beihua University（Natural Science）

基　　金：湖北省科技支撑计划项目(2014BBA182)

摘　　要：目的 探讨阿替普酶(rt-PA)与尿激酶(UK)经导管接触性溶栓(CDT)治疗亚急性下肢动脉闭塞症(DVT)患者的临床疗效.方法 选择100例亚急性DVT患者,根据随机数字表法分为UK-CDT组(n=50)与Rt-PA-CDT组(n=50),比较两组患者治疗疗效、静脉通畅度评分、双下肢周径差及并发症发生情况.结果 rt-PA-CDT组患者治疗总有效率高于UK-CDT组(χ^2=5.086,P=0.024);在治疗后Pos-1,Pos-2时,Rt-PA-CDT组患者的静脉通畅度评分及双侧大腿、小腿周径差均低于UK-CDT组(P<0.05);Rt-PA-CDT组患者轻度出血率高于UK-CDT组(χ^2=9.756,P=0.002);Rt-PA-CDT组患者的血栓后综合征(PTS)发生率低于UK-CDT组(χ^2=4.891,P=0.027);两组患者PTS严重程度比较差异无统计学意义(P>0.05).结论 经CDT联合rt-PA溶栓效果好,能够显著降低亚急性下肢动脉闭塞症患者PTS发生率.Objective To investigate the clinical efficacy of catheter-directed contact thrombolysis ( CDT) with rt-PA and urokinase (UK) in the treatment of subacute lower extremity arterial occlusion.Method 100 patients with subacute DVT were treated.According to the random number table method,they were divided into group UK-CDT ( n =50) and group Rt-PA-CDT ( n =50).The curative effect,venous patency score,peripheral circumference difference of the lower limbs and complications were compared between2 groups. Results The total effective rate of Rt-PA-CDT group was higher than that of UK-CDT group (χ^2 =5.086, P =0.024);At the time of Pos-1 and Pos-2 after treatment,the scores of venous patency and the circumference difference of bilateral thighs and calves in Rt-PA-CDT group were lower than those in UK-CDT group( P <0.05).The incidence of PTS in Rt- PA-CDT group was lower than that in UK-CDT group (χ^2 =4.891 , P =0.027),and there was no significant difference in the severity of PTS between the two groups ( P >0.05). Conclusion The effect of CDT combined with Rt-PA thrombolytic is better,which can improve symptoms significantly,reduce the incidence of PTS in patients with subacute lower extremity arterial occlusion.

关 键 词：阿替普酶 尿激酶 导管接触性溶栓 疗效 并发症 

分 类 号：R654.3[医药卫生—外科学]