不同抗凝时长对下肢深静脉血栓形成伴Cockett综合征支架植入患者支架畅通率及Villalta评分的影响  

Effects of Different Anticoagulant Duration on Stent Unblocked Rate and Villalta Score in Patients with Lower Extremity Deep Venous Thrombosis Complicated with Cockett Syndrome

作　　者：王沆[1] 严骏 雷云宏[1] 林君垚 林隆辉[1] 黄烽[1] WANG Hang;YAN Jun;LEI Yunhong;LIN Junyao;LIN Longhui;HUANG Feng(Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建省立医院,福建福州350001

出　　处：《中外医学研究》2022年第30期26-30,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：国家临床重点专科建设项目(国卫办医函【2013】544号)。

摘　　要：目的:对比不同抗凝时长在下肢深静脉血栓形成伴Cockett综合征支架植入术后的作用。方法:纳入2018年1月-2020年12月福建省立医院诊治的150例下肢深静脉血栓形成伴Cockett综合征患者,所有患者均行髂静脉支架植入术,根据术后抗凝时间分为常规抗凝组(对照组,n=75,抗凝时间6个月)和延长抗凝组(观察组,n=75,抗凝时间>6个月),对比两组支架畅通率、血栓清除率、Villalta评分和肢体周径差,以及凝血功能和出血事件发生率。结果:两组治疗后6、12个月支架畅通率和血栓清除率、出血事件发生率比较,差异均无统计学意义(P>0.05);治疗后6、12个月,两组小腿周径差和大腿周径差较治疗前均下降(P<0.05),但两组对比差异均无统计学意义(P>0.05);治疗后6、12个月,两组症状、体征和Villalta总评分、D-二聚体水平较治疗前均降低,活化部分凝血酶原时间和凝血酶原时间较治疗前均延长,且观察组均优于对照组(P<0.05)。结论:延长下肢深静脉血栓形成伴Cockett综合征支架植入患者术后抗凝时间,可减轻临床症状,对支架畅通度、血栓清除效果和肢体周径差无明显改善,且未增加出血事件发生风险。Objective:To compare the effects of different anticoagulant duration on patients with lower extremity deep venous thrombosis complicated with Cockett syndrome after stent implantation.Method:A total of 150 patients with lower extremity deep vein thrombosis complicated with Cockett syndrome who treated in Fujian Provincial Hospital from January 2018 to December 2020 were enrolled.All patients underwent iliac vein stenting,according to postoperative anticoagulant time they were divided into conventional anticoagulant group (the control group,n=75,anticoagulant time 6 months) and extended anticoagulant group (the observation group,n=75,anticoagulant time >6 months).The stent unblocked rate,thrombus clearance rate,Villalta score and limb circumference difference,and coagulation function and incidence of bleeding events were compared between two groups.Result:There were no significant differences in the stent patency rate,thrombus clearance rate and incidence of bleeding events between two groups at 6 and 12 months after treatment (P>0.05).At 6 and 12 months after treatment,the differences in the circumference of calf and the circumference of thigh in two groups were decreased compared with those before treatment (P<0.05),but there were no significant differences between two groups (P>0.05).At 6 and 12 months after treatment,the symptoms,signs,Villalta total scores and D-dimer levels in two groups were lower than those before treatment,and the activated partial prothrombin time and prothrombin time were both prolonged compared with those before treatment,the observation group were better than those of the control group (P<0.05).Conclusion:Prolonging the postoperative anticoagulant time of patients with lower extremity deep venous thrombosis complicated with Cockett syndrome can alleviate the clinical symptoms,and has no significant improvement in stent unblocked degree,thrombosis clearance effect and limb circumference difference,and does not increase the risk of bleeding events.

关 键 词：下肢深静脉血栓形成 COCKETT综合征 支架置入 支架畅通度 Villalta评分 凝血功能 

分 类 号：R654.4[医药卫生—外科学]