人工肝支持系统治疗肝衰竭术后并发下肢深静脉血栓形成的处理策略  

Treatment strategies of deep venous thrombosis after artificial liver treatment in patients with liver failure

作　　者：苏倩[1] 张莉[1] 夏玲玲[1] 郜玉峰[1] 李家斌[1] SU Qian;ZHANG Li;XIA Lingling;GAO Yufeng;LI Jiabin(Department of Infectious Diseases,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China)

机构地区：[1]安徽医科大学第一附属医院感染病科,安徽合肥230022

出　　处：《安徽医药》2022年第8期1562-1566,共5页Anhui Medical and Pharmaceutical Journal

基　　金：安徽省教育厅高校科学研究项目(KJ2021A0305);安徽医科大学2020年度校科研基金项目(2020xkj179)。

摘　　要：目的明确人工肝支持系统(ALSS)治疗肝衰竭(LF)病人术后并发下肢深静脉血栓形成的处理策略。方法回顾性分析2019年1月至2021年9月安徽医科大学第一附属医院收治的经ALSS治疗的肝衰竭病人216例,选择有临床症状并经彩色多普勒超声证实的6例下肢深静脉血栓形成(DVT)病人为研究对象,分析DVT的处理策略。结果6例病人经过抗凝、导管内溶栓、下肢静脉滤器置入联合机械吸栓术后均安全拔管,未发现与治疗相关并发症。结论肝衰竭并发DVT治疗难度大,低分子肝素(LMWH)抗凝可能是首选,根据病人情况可以再选择导管内溶栓或放置临时滤器+机械吸栓术。Objective To clarify the management strategies of deep venous thrombosis(DVT)of lower extremities in patients with liver failure(LF)after the treatment of artificial liver support system(ALSS).Methods A retrospective analysis was performed on 216 patients with LF treated with ALSS in the First Affiliated Hospital of Anhui Medical University from January 2019 to September 2021,and 6 patients with DVT in lower extremities with clinical symptoms confirmed by Color Doppler Flow Imaging were selected as the research objects.Clinical data of the patients were analyzed and management strategies were discussed.The management strategies of DVT were analyzed.Results All the 6 patients underwent safe extubation after anticoagulation,intraductal thrombolysis,lower extremities venous filter implantation combined with thrombolysis,and no treatment-related complications were found.Conclusions The treatment of LF complicated with DVT is difficult,low molecular weight heparin(LMWH)anticoagulation may be the first choice.Intracatheter thrombolysis or temporary filter plus mechanical thrombolysis are also selected according to the patient's condition.

关 键 词：静脉血栓形成 肝衰竭 下肢 人工肝支持系统 

分 类 号：R575.3[医药卫生—消化系统]