抗凝溶栓联合下腔静脉滤器置入治疗下肢深静脉血栓的疗效及安全性分析  

Efficacy and Safety of Anticoagulation and Thrombolysis Combined with Inferior Vena Cava Filter Implantation in the Treatment of Lower Extremity Deep Venous Thrombosis

作　　者：伍成文 胥雄飞 何虎强 何延政 刘勇 Wu Chengwen;Xu Xiongfei;He Huqiang;He Yanzheng;Liu Yong(Department of Vascular Surgery, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China)

机构地区：[1]西南医科大学附属医院血管外科

出　　处：《成都医学院学报》2019年第4期443-446,450,共5页Journal of Chengdu Medical College

基　　金：四川省科技厅科技支撑计划(No:2012SZ60184)

摘　　要：目的分析抗凝、导管溶栓联合下腔静脉滤器置入治疗下肢深静脉血栓(DVT)形成的疗效及安全性。方法回顾性分析2016年1月至2018年9月经西南医科大学附属医院诊治的162例DVT患者临床资料,根据治疗方式不同,分为观察组94例与对照组68例,观察组采用抗凝、导管溶栓联合下腔静脉滤器置入治疗,对照组行抗凝、系统溶栓治疗,治疗2周后,观察两组临床疗效、健患肢周径差变化,并比较两组一般住院情况、并发症发生率,分析观察组治疗安全性。结果治疗2周后,两组疗效比较差异有统计学意义(P<0.05),且观察组总有效率为90.43%,高于对照组的76.67%(P<0.05);观察组大腿周径差、小腿周径差均低于对照组(P<0.05);观察组平均住院时间、溶栓治疗时间及尿激酶总用量均低于对照组(P<0.05);观察组肺栓塞发生率(0.00%)低于对照组(10.29%)(P<0.05)、并发症总发生率(9.57%)低于对照组(25.00%)(P<0.05);观察组未见导管、滤器置入相关不良事件。结论抗凝、导管溶栓联合下腔静脉滤器置入治疗下肢DVT,可提高临床疗效,有效减少健患肢周径差、住院时间、溶栓治疗时间及尿激酶用量,同时降低患者肺栓塞及并发症总发生率,安全性良好。Objective To analyze the efficacy and safety of anticoagulation and catheter thrombolysis combined with inferior vena cava filter implantation in the treatment of lower extremity deep venous thrombosis (DVT). Methods The clinical data of 162 DVT patients treated in Affiliated Hospital of Southwest Medical University from January of 2016 to September of 2018 were analyzed retrospectively. Those patients were divided into the observation group with 94 cases and control group with 68 cases according to different treatment methods. The observation group was treated with anticoagulation and catheter thrombolysis combined with inferior vena cava filter implantation, while the control group was treated with anticoagulation and systemic thrombolysis. After 2 weeks of treatment, the clinical efficacy and circumference difference of suffered limbs were observed in the two groups. The hospitalization and complication incidence were compared between the two groups. The treatment safety of the observation group was analyzed. Results After 2 weeks of treatment, there was a significant difference in the efficacy between the two groups ( P <0.05), and the total effective rate of the observation group (90.43%) was significantly higher than that of the control group (76.67%)( P <0.05). The circumference differences of thigh and shank in the observation group were significantly less than those in the control group ( P <0.05). The average hospital stay, thrombolytic therapy time and total urokinase dosage in the observation group were significantly less than those in the control group ( P <0.05). The incidence of pulmonary embolism in the observation group (0.00%) was significantly lower than that in the control group (10.29%)( P <0.05), and the total incidence of complications in the observation group (9.57%) was significantly less than that in the control group (25.00%)( P <0.05). There were no adverse events related to the implantation of catheter and filter in the observation group. Conclusion Anticoagulation and catheter thromb

关 键 词：下肢深静脉血栓 抗凝 导管溶栓 下腔静脉滤器置入 疗效 安全性 

分 类 号：R473.6[医药卫生—护理学]