术后功能恢复介入时间对下肢深静脉血栓溶栓术临床疗效的影响  

Effect of postoperative functional recovery intervention time on the clinical efficacy of thrombolysis for lower extremity deep vein thrombosis

作　　者：黄丽丽[1] 陈粹[1] 陆静[1] 李金枝[1] 彭莉 Huang Lili;Chen Cui;Lu Jing;Li Jinzhi;Peng Li(Department of Thyroid Vascular Surgery,Deyang People's Hospital,Deyang 618000,Sichuan,China)

机构地区：[1]德阳市人民医院甲状腺血管外科,四川德阳618000

出　　处：《血管与腔内血管外科杂志》2022年第11期1337-1341,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨术后功能恢复介入时间对下肢深静脉血栓(LDVT)溶栓术临床疗效的影响。方法收集2019年1月至2022年1月于德阳市人民医院接受导管接触性溶栓(CDT)治疗的80例LDVT患者的临床资料,根据CDT术后开展功能恢复介入时间的不同将其分为早期组(n=43,术后3 d内开展功能恢复)和常规组(n=37,术后3 d后开展功能恢复)。首次溶栓治疗后3 d观察两组患者的溶栓疗效,统计两组患者的溶栓指标,比较两组患者溶栓前、溶栓后(出院前)的健患肢周径差,术后并发症发生情况,溶栓前、溶栓后1个月的舒适状况量表(GCQ)评分、视觉模拟评分法(VAS)评分、血栓形成后综合征(PTS)评分。结果早期组患者溶栓疗效优于常规组患者,差异有统计学意义(P<0.05)。早期组患者溶栓时间、尿激酶用量、住院时间均明显少于常规组患者,差异均有统计学意义(P<0.01)。溶栓后,两组患者健患肢髌骨上缘15 cm周径差、髌骨下缘15 cm周径差均明显小于本组溶栓前,早期组患者上述指标均明显小于常规组患者,差异均有统计学意义(P<0.01)。两组患者术后并发症发生率比较,差异无统计学意义(P>0.05)。溶栓后1个月,两组患者GCQ评分均明显高于本组溶栓前,VAS评分均明显低于本组溶栓前,且早期组患者VAS、PTS评分均明显低于常规组患者,差异均有统计学意义(P<0.01)。结论CDT术后早期(3 d以内)开展LDVT的功能恢复介入治疗可促进患者术后恢复,辅助提高溶栓疗效,进一步减轻患者的临床症状,预后安全性较好。Objective To investigate the effect of postoperative functional recovery intervention time on the clinical efficacy of lower extremity deep vein thrombosis(LDVT).Method The clinical data of 80 patients with LDVT who received catheter-directed thrombolysis(CDT)in Deyang People’s Hospital from January 2019 to January 2022 were collected.They were divided into early group(n=43,functional recovery within 3 days after surgery)and routine group(n=37,functional recovery 3 days after surgery)according to the time of functional recovery after CDT.The thrombolytic efficacy of the two groups was observed 3 days after the primary thrombolytic therapy,the thrombolysis indicators of the two groups of patients were counted.The difference in circumference of healthy and affected extremity were compared between the two groups before and after the thrombolysis(before discharge).The postoperative complications of the two groups were compared.The general comfort questionnaire(GCQ)score,visual analogue scale(VAS)score,and post-thrombotic syndrome(PTS)score were compared between the two groups before and 1 month after thrombolysis.Result The efficacy of thrombolysis in the early group was better than that in the conventional group,the difference was statistically significant(P<0.05).The thrombolysis time,urokinase dosage,and hospitalization time of patients in the early group were significantly shorter than those in the routine group,the differences were statistically significant(P<0.01).After thrombolysis,the 15 cm circumference difference of the upper border of the patella and the 15 cm circumference difference of the lower border of the patella in the two groups of patients were significantly smaller than those before thrombolysis in the same group,the above indexes of patients in the early group were significantly lower than those in the routine group,the differences were statistically significant(P<0.01).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).One month

关 键 词：下肢深静脉血栓 导管接触性溶栓 术后功能恢复 介入时间 临床疗效 

分 类 号：R543[医药卫生—心血管疾病]