Angiojet机械血栓清除对比导管溶栓在治疗髂股静脉血栓形成中的2年随访研究  

A 2-year follow-up study of Angiojet percutaneous mechanical thrombectomy versus catheter-directed thrombolysis in treatment of acute iliofemoral deep vein thrombosis

作　　者：黄天安 金泳海[2] 陈卓[1] 洪鑫[1] 印于 江晓冬 陈栋健 丁文彬[1] HUANG Tian'an;JIN Yonghai;CHEN Zhuo;HONG Xin;YIN Yu;JIANG Xiaodong;CHEN Dongjian;DING Wenbin(Department of Interventional Radiology,Nantong First People's Hospital,Nantong,Jiangsu Province 226001,China;Department of Vascular and Interventional Radiology,the First Affiliated Hospital of Soochouu University,Suzhou,Jiangsu Province 215006,China)

机构地区：[1]南通市第一人民医院介入科,江苏南通226001 [2]苏州大学附属第一医院介入血管科,江苏苏州215006

出　　处：《实用放射学杂志》2021年第12期2056-2060,共5页Journal of Practical Radiology

摘　　要：目的对比Angiojet机械血栓清除(PMT)和导管溶栓(CDT)治疗髂股静脉血栓形成,术后2年下肢深静脉血栓形成后综合征(PTS)的发生情况。方法回顾性分析57例因髂股静脉血栓形成行介入治疗患者的临床资料。A组(30例)行PMT治疗,B组(27例)行CDT治疗。随访2年,比较2组PTS发生率、严重程度及慢性静脉功能不全问卷(CIVIQ)评分差异。结果2年随访,2组患者PTS发生率差异无统计学意义[Villalta评分≥5或者溃疡:33.33%vs 48.15%;优势比(OR)=0.538;95%置信区间(CI)0.185~1.571;χ^(2)=1.296;P=0.290],重度PTS对比差异有统计学意义(Villalta评分≥15或者溃疡:13.33%vs 40.74%;OR=0.121;95%CI 0.017~0.867;χ^(2)=4.960;P=0.039;静脉临床严重程度评分(VCSS)≥8:13.33%vs 44.44%;OR=0.056;95%CI 0.005~0.613;χ^(2)=7.304;P=0.019)。CIVIQ评分对比差异有统计学意义(74.53±11.22 vs 66.03±14.06,χ^(2)=2.502;P=0.016)。结论Angiojet PMT对比CDT治疗髂股静脉血栓形成,2年PTS发生率无明显差异,Angiojet PMT能更好地改善PTS临床症状。Objective To compare the occurrence circumstance of postoperative 2-year post-thrombotic syndrome(PTS)in Angiojet percutaneous mechanical thrombectomy(PMT)and catheter-directed thrombolysis(CDT)in the treatment of acute iliofemoral deep vein thrombosis.Methods The clinical data of 57 patients with acute iliofemoral deep vein thrombosis were analyzed retrospectively.The patients were divided into group A(n=30)and group B(n=27).For the patients of group A,the PMT was performed.For the patients of group B,the CDT was performed.Followed for 2 years,the difference of incidence rate,severity of PTS and chronic venous insufficiency questionnaire CIVIQ(score were compared.Results Within 2-year follow-up,there was no difference in the incidence rate of PTS[Villalta scale≥5 or ulcer:33.33%vs 48.15%;odds ratio(OR)=0.538;95%confidence interval(Cl)0.185-1.571;χ^(2)=1.296;P=0.290],The difference of severity of PTS was statistically significant(Villalta scale≥5 or ulcer:13.33%vs 40.74%;OR=0.121;95%CI 0.017-0.867;χ^(2)=4.960;P=0.039;Venous clinical severity score(VCSS)≥8:13.33%vs 44.44%;OR=0.056;95%CI 0.005-0.613;χ^(2)=7.304;P=0.019).The difference of CIVIQ score was statistically significant(74.53±11.22 vs 66.03±14.06,χ^(2)=2.502;P=0.016).Conclusion In treatment of acute iliofemoral deep vein thrombosis,Angiojet PMT has no difference with CDT on the incidence rate of postoperative 2-year PTS.But,Angiojet PMT can better improve the clinical symptoms of PTS.

关 键 词：机械血栓清除 导管溶栓 下肢深静脉血栓形成后综合征 随访 

分 类 号：R815[医药卫生—放射医学] R681.8[医药卫生—临床医学]