三种不同入路置管方式介入治疗急性下肢深静脉血栓疗效研究  

Curative effect of different accesses of catheter-directed thrombolysis in treatment of acute deep vein thrombosis in lower extremity

作　　者：蒋俊[1] 李俊杰[1] 刘曙民 高万河 韩雪[1] 冯建新[1] JIANG Jun;LI Junjie;LIU Shumin;GAO Wanhe;HAN Xue;FENG Jianxin(Department of Intervention,Baoji People’s Hospital,Baoji 721000,China)

机构地区：[1]宝鸡市人民医院介入科,陕西宝鸡721000

出　　处：《陕西医学杂志》2021年第11期1371-1374,共4页Shaanxi Medical Journal

摘　　要：目的:探讨三种不同入路置管方式介入治疗急性下肢深静脉血栓(DVT)的疗效。方法:选取急性下肢DVT患者90例,按照入路置管方式的不同,分为A组、B组和C组,各30例。其中A组选择小隐静脉入路,B组选择经腘静脉入路,C组选择经健侧股静脉入路。比较三组患者的消肿率、静脉通畅率、血栓形成后综合征(PTS)发生率以及并发症发生率。结果:与治疗前相比,治疗后三组的大腿周径差、血栓程度评分均明显降低(均P<0.05);治疗后,三组大腿周径差、消肿率、血栓程度评分、PTS发生率和并发症发生率比较,差异均无统计学意义(均P>0.05);治疗后B组的静脉通畅率明显高于A组和C组(均P<0.05),A组和C组的静脉通畅率比较,差异无统计学意义(P>0.05)。结论:三种入路置管方式治疗急性下肢DVT,均取得较好的治疗效果,经腘静脉入路静脉通畅率高,临床中,应根据患者的个体情况,灵活选择合适的入路方式,以获取最佳的治疗效果。Objective:To study the effect of different accesses of catheter-directed thrombolysis in the treatment of acute deep vein thrombosis(DVT)in lower extremity.Methods:According to the different accesses of catheterization,90 patients with acute DVT in lower extremity were divided into group A,group B and group C,with 30 cases in each.Group A was carried out via the small saphenous vein access,group B was carried out via the popliteal vein access,and group C was carried out via the femoral vein access in intact side.The edema reduction rate,venous patency rate,incidence of post-thrombotic syndrome(PTS),and complication rate were compared among the three groups.Results:After treatment,the thigh circumference difference and thrombosis degree scores of the three groups were significantly reduced(all P<0.05);the thigh circumference difference,swelling rate,thrombosis degree score,PTS incidence and complication rate of the three groups were not significantly different(all P>0.05);the venous patency rate of group B was significantly higher than that of group A and C(all P<0.05),and there was no statistical difference in the venous patency rate between group A and group C(P>0.05).Conclusion:Three accesses of catheter-directed thrombolysis for acute deep vein thrombosis in lower extremity have achieved good therapeutic effect and safety.The venous patency rate of popliteal vein access is highest.To obtain better therapeutic effect,we should choose the appropriate way flexibly according to the individual condition of the patient.

关 键 词：急性下肢深静脉血栓 介入治疗 腘静脉 小隐静脉 健侧股静脉 静脉通畅率 

分 类 号：R659[医药卫生—外科学]