改良导管溶栓方案对急性深静脉血栓患者疗效及安全性的影响  

Influence of modified catheter thrombolytic regimen on clinical efficacy and safety of patients with acute DVT

作　　者：王国涛 张伟杰 王丙龙 Wang Guotao;Zhang Weijie;Wang Binglong(Department of Vascular Surgery,the Central Hospital of Yuncheng,Yuncheng,Shanxi 044000,China)

机构地区：[1]运城市中心医院血管外科,山西省044000

出　　处：《中国基层医药》2020年第18期2249-2252,共4页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨改良导管溶栓方案对急性深静脉血栓(DVT)患者疗效及安全性的影响。方法选取运城市中心医院2016年3月至2018年3月收治的急性DVT患者共86例,采用随机抽签法分为对照组(43例)和观察组(43例),对照组采用常规导管溶栓方案,观察组采用改良导管溶栓方案治疗;比较两组术后消肿率、术后双下肢周径差、手术前后静脉通畅评分、术后静脉通畅率、手术时间、溶栓费用、尿激酶用量、术后血红蛋白减少量及术后并发症发生率。结果两组术后消肿率、术后双下肢周径差、术后静脉通畅评分及术后静脉通畅率比较差异均无统计学意义[(81.52±3.05)%比(84.66±4.29)%;(1.10±0.34)cm比(1.24±0.39)cm;(2.40±0.53)分比(2.51±0.59)分;(63.16±6.98)%比(64.81±7.15)%,t=0.58、0.70、0.16、0.25,均P>0.05];观察组手术时间和术后血红蛋白减少量均显著多于对照组[(42.81±6.17)min比(20.86±3.02)min;(12.84±3.96)g/L比(4.13±1.02)g/L,t=4.26、3.51,P<0.05];观察组溶栓费用和尿激酶用量均显著少于对照组[(4129.25±584.57)元比(7251.49±695.70)元;(79.17±10.79)万U比(217.13±38.76)万U;t=7.14、10.26,均P<0.05];同时两组术后并发症发生率差异无统计学意义(11.63%比9.30%,χ2=0.82,P>0.05)。结论改良导管溶栓方案用于急性DVT患者总体疗效和安全性与常规导管溶栓方案相近,并可有效降低治疗费用和尿激酶用量,但亦存在增加操作用时和手术出血量风险。Objective To investigate the influence of modified catheter thrombolytic regimen on clinical efficacy and safety of patients with acute deep vein thrombosis(DVT).Methods From March 2016 to March 2018,86 patients with acute DVT were chosen in the Central Hospital of Yuncheng and randomly divided into two groups by random drawing method,with 43 cases in each group.The control group received routine catheter thrombolytic regimen,and the observation group received modified catheter thrombolysis regimen.The postoperative detumescence rate,postoperative lower limb circumference difference,venous patency score before and after operation,postoperative venous patency rate,operation time,thrombolytic costs,urokinase dosage,reduction amount of hemoglobin after operation and incidence of complications after operation of the two groups were compared.Results There were no statistically significant differences in the postoperative detumescence rate,postoperative lower limb circumference difference,venous patency score after operation,postoperative venous patency rate between the two groups[(81.52±3.05)%vs.(84.66±4.29)%;(1.10±0.34)cm vs.(1.24±0.39)cm;(2.40±0.53)points vs.(2.51±0.59)points;(63.16±6.98)%vs.(64.81±7.15)%;t=0.58,0.70,0.16,0.25,all P>0.05].The operation time and reduction amount of hemoglobin after operation of the observation group were significantly more than those of the control group[(42.81±6.17)min vs.(20.86±3.02)min;(12.84±3.96)g/L vs.(4.13±1.02)g/L;t=4.26,3.51,P<0.05].The thrombolytic costs and urokinase dosage of the observation group were significantly less than those of the control group[(4129.25±584.57)CNY vs.(7251.49±695.70)CNY;(79.17±10.79)×104U vs.(217.13±38.76)×104U;t=7.14,10.26,all P<0.05].There was no statistically significant difference in the incidence of complications after operation between the two groups(11.63%vs.9.30%,χ2=0.82,P>0.05).Conclusion Compared with routine catheter thrombolytic regimen,modified catheter thrombolytic regimen in the treatment of patients with acute DV

关 键 词：静脉血栓形成 血栓溶解疗法 手术后并发症 血红蛋白类 手术时间 疗效比较研究 

分 类 号：R654.4[医药卫生—外科学]