腔内治疗方式的选择对髂股静脉血栓预后的影响  

Effect of endovascular treatment on the prognosis of iliofemoral vein thrombosis

作　　者：王斌[1] 杨建平[1] 方青波[1] 管圣[1] 戈小虎[1] WANG Bin;YANG Jianping;FANG Qingbo(Department of Vascular Surgery,People’s Hospital of Xinjiang Uygur Autonomous Region,Xinjiang,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院血管外科,乌鲁木齐830001

出　　处：《临床外科杂志》2021年第8期767-769,共3页Journal of Clinical Surgery

摘　　要：目的探讨不同腔内治疗方式对急性髂股静脉血栓形成预后的影响。方法回顾性分析我中心2015年1月~2016年9月经彩色多普勒超声确诊为急性髂-股静脉血栓形成(Iiiacfemoral venous thrombosis,IFVT)的病人102例,分别采取不同方式的腔内治疗方案:导管定向溶栓(catheter-directed thrombolysis,CDT),Angio Jet机械血栓清除(pharmacomechanical thrombectomy,PMT)和Angio Jet机械血栓清除联合导管溶栓(PMT+CDT)。将符合研究纳入标准的102例病人作为研究对象,对术后12个月、24个月、36个月及48个月随访资料进行统计分析,评估患肢静脉血栓复发率,血栓后综合征(post-thrombotic syndrome,PTS)发生率和严重程度。结果随访48个月,102例病人随访的整体血栓复发率19.6%,PTS发生率22.5%。随访过程中三组的血栓复发率及PTS发生率比较差异无统计学意义(P> 0.05)。随访24个月及以上时,PMT组和PMT+CDT组Villalta评分均明显低于溶栓组,三组比较有统计学意义(P <0.05)。结论三种腔内方法均可有效清除血栓,保护静脉功能,在IFVT的复发和PTS发生方面均有积极预防作用。随访24个月及以上时,PMT组和PMT+CDT组的严重程度明显低于CDT组。Objective To explore the effects of different intracavitary treatments on the prognosis of acute iliofemoral vein thrombosis. Methods The patients with acute iliofemoral vein thrombosis( Iiiacfemoralvenousthrombosis,IFVT) diagnosed by color Doppler ultrasound in our center from January 2015 to September 2016 were retrospectively analyzed. Different methods of intracavitary treatment were adopted:catheter directed thrombolysis( CDT),Angio Jet pharmacomechanical thrombectomy( PMT) and pharmacomechanical thrombectomy combined with catheter directed thrombolysis( PMT + CDT). The follow-up data of 12 months,24 months,36 months and 48 months after operation were statistically analyzed to evaluate the recurrence rate of venous thrombosis,the incidence and severity of post-thrombotic syndrome( PTS). Results During the 48-month follow-up,the overall thrombus recurrence rate of 102 patients was 19. 6% and the incidence of PTS was 22. 5%. During the follow-up,there was no significant difference in the recurrence rate of thrombus and the incidence of PTS among the three groups( P >0. 05). When the patients were followed up for 24 months or more,the Villalta scores in the PMT group and the PMT + CDT group were significantly lower than those in the CDT group,and there was significant difference among the three groups( P < 0. 05). Conclusion The three endovascular therapy methods can effectively remove thrombus,protect venous function,and play an active role in preventing the recurrence of DVT and the occurrence of PTS. During the follow-up of 24 months or more,the severity of PTS in the PMT group and the PMT + CDT group was significantly lower than that in the CDT group.

关 键 词：深静脉血栓形成 腔内治疗 导管溶栓 机械血栓清除 血栓后综合征 

分 类 号：R654.4[医药卫生—外科学]