经小隐静脉与经腘静脉入路置管溶栓治疗急性下肢深静脉血栓的对比研究  

A comparative study of catheter thrombolysis via small saphenous vein and popliteal vein for acute deep venous thrombosis of lower extremities

作　　者：方灿军[1] 潘力生[1] 丁振[1] 聂宗杰[1] 查振平 邱海军 梅文俊[1] 汪文锐 Can-jun Fang;Li-sheng Pan;Zhen Ding;Zong-jie Nie;Zhen-ping Zha;Hai-jun Qiu;Wen-jun Mei;Wen-rui Wang(Department of Vascular Surgery,Anqing Municipal Hospital,Anhui Medical University,Anqing,Anhui 246003,China)

机构地区：[1]安徽医科大学附属安庆医院血管外科,安徽安庆246003

出　　处：《中国现代医学杂志》2020年第5期91-94,共4页China Journal of Modern Medicine

基　　金：安徽医科大学校科研基金项目(No:2017xkj067)。

摘　　要：目的探讨经腘静脉穿刺入路置管溶栓治疗急性下肢深静脉血栓(DVT)的应用价值。方法62例经造影或彩超明确诊断的急性下肢DVT患者,随机分为A、B组两组。A组(32例)经患肢腘静脉入路置管溶栓,B组(30例)经患肢小隐静脉入路置管溶栓。从治疗后患肢消肿率、静脉通畅度、治疗期并发症发生率等方面对两组患者进行观察比较。结果A组大腿消肿率为(88±13)%,B组为(85±22)%,A组小腿消肿率(82±16)%,B组为(84±15)%;A组静脉通畅度(84.55±2.34)%,B组(84.52±3.24)%。两组疗效比较,差异无统计学意义(P>0.05)。与B组比较,A组尿激酶使用量少,疗程短且并发症发生率低(P<0.05)。结论经腘静脉穿刺置管溶栓治疗急性下肢DVT形成优于经小隐静脉途径置管溶栓,其具有疗程短、尿激酶使用量少、并发症轻等优点。Objective To evaluate the clinical effectiveness of catheterization via the popliteal vein for thrombolysis in acute deep vein thrombosis of lower extremities.Methods Patients with documented acute lower extremity deep vein thrombosis were divided into two groups.Patients in group A received CDT with venous access through the ipsilateral popliteal vein.The patients in group B received CDT via the ipsilateral popliteal vein.Clinical efficacy was evaluated by measuring the circumferences between the normal and affected limbs before and after treatment;the venous patency score,the rate of patency improvement based on venographic results,and the clinical results including the limbs edema reduction rate,the mean complications;were all compared between the two groups.Results The limbs edema reduction rates of thigh were[(88±13)VS 85±22)%],those of leg were[(82±16)VS(84±15)%],likewise,the rates of venous patency improvement were[(84.55±2.34)VS(84.52±3.24)%].There was no significant difference in efficacy between the two groups(P>0.05).The course of treatment in group A was shorter and the dosage of urokinase was less compared with group B(P<0.05).The incidence of complications in group A was lower than that in group B(P<0.05).Conclusions Thrombolysis via popliteal vein catheter is superior to catheter thrombolysis via small saphenous vein in the treatment of acute deep venous thrombosis of lower extremities.It has the advantages of short course of treatment,less use of urokinase and low complications.

关 键 词：下肢深静脉血栓 小隐静脉 腘静脉 置管溶栓 

分 类 号：R543.6[医药卫生—心血管疾病]