经膝下静脉入路行经导管接触性溶栓治疗下肢深静脉血栓形成疗效  

Curative effect of CDT in treatment of deep venous thrombosis of lower extremity via sub⁃knee vein access

作　　者：罗翰林 白骁 许卫国 LUO Hanlin;BAI Xiao;XU Weiguo(Department of Interventional Medicine,Zhuhai Hospital Affiliated to Ji′nan University(Zhuhai People′s Hospital),Zhuhai 519000,China)

机构地区：[1]暨南大学附属珠海医院(珠海市人民医院)介入医学科,广东珠海519000

出　　处：《实用医学杂志》2022年第16期2042-2045,2050,共5页The Journal of Practical Medicine

基　　金：国家自然基金重大仪器专项子课题(编号:62027901);珠海市人民医院2019年度培育项目(编号:2019PY-23)。

摘　　要：目的探讨急性混合型下肢深静脉血栓形成(deep venous thrombosis,DVT)经膝下穿刺入路行导管接触性溶栓(catheter-directed thrombolysis,CDT)治疗的可行性及临床疗效分析。方法回顾性分析2020年1月至2021年12月本中心收治的急性混合型DVT患者的临床资料,根据穿刺入路不同分为观察组与对照组,观察组经胫前(venae tibiales anteriores)或胫后静脉(venae tibiales posteriores)穿刺行CDT治疗,对照组经腘静脉(popliteal vein)入路行CDT治疗。收集两组患者的健患侧周径差、患肢消肿率、静脉通畅率、使用尿激酶(urokinase)总量、住院天数、术后并发症进行比较分析。结果观察组血栓清除效果(1级1例,2级1例,3级27例),术后静脉通畅率(86.2±12.4)%及术后porter评分(1.2±0.9),术后小腿周径差(1.0±0.8)cm和小腿消肿率(70.3±19.0)%等临床疗效方面明显优于对照组,差异有统计学意义(P<0.05)。结论经膝下静脉入路行CDT治疗混合型DVT与腘静脉入路比较在临床疗效方面有明显优势,同时膝下静脉入路应用未增加患者术后并发症的发生。Objective To investigate the feasibility and clinical efficacy of catheter⁃directed thrombolysis(CDT)for acute mixed lower extremity deep venous thrombosis(DVT)via sub⁃knee vein access.Methods The clinical data of patients with acute mixed DVT treated in our unit from January 2020 to December 2021 were retro⁃spectively analyzed,and the patients were divided into observation group and control group according to different accesses.CDT via anterior or posterior tibial vein access was performed in the observation group,and in the control group CDT via the popliteal vein access was applied.Perimeter difference of the healthy side and affected side,detumescence rate of the affected limb,venous patency rate,the total amount of urokinase used,the length of hospi⁃tal stay,and postoperative complications of the two groups were recorded and compared.Results Clinical efficacy in terms of thrombus removal effect(1 case of grade 1,1 case of grade 2,and 27 cases of grade 3),postoperative venous patency rate(86.2±12.4)%and postoperative porter score(1.2±0.9),postoperative calf circumference difference(1.0±0.8)cm,and lower leg swelling rate(70.3±19.0)%,in the observation group was better when compared with those in the control group,showing statistical significance(P<0.05).Conclusion Compared with popliteal vein access,CDT via inferior knee vein in the treatment of mixed DVT has obvious advantages in postop⁃erative clinical efficacy,and the application of the inferior knee vein approach does not increase the incidence of postoperative complications in patients.

关 键 词：下肢深静脉血栓形成 导管接触性溶栓 胫后静脉 

分 类 号：R445.4[医药卫生—影像医学与核医学]