溶栓药物联合大腔导管抽吸治疗下肢深静脉血栓34例  

Clinical study of thrombolytic drugs combined with large lumen catheter aspiration in the treatment of lower extremity deep vein thrombosis in 34 cases

作　　者：苏威强 沈冬冬 付艳忠[1] SU Weiqiang;SHEN Dongdong;FU Yanzhong(Author Affiliation:Department of Vascular Surgery,Jiaozuo Second People's Hospital,Jiaozuo,Henan 454000,China)

机构地区：[1]焦作市第二人民医院血管外科,河南焦作454000

出　　处：《安徽医药》2023年第5期954-958,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的 探究溶栓药物联合大腔导管抽吸治疗下肢深静脉血栓的临床效果。方法 前瞻性选取焦作市第二人民医院2018年6月至2020年12月下肢深静脉血栓病人68例,按照随机数字表法分组,各34例。对照组给予大腔导管抽吸治疗,观察组给予溶栓药物经腘静脉置鞘预处理联合大腔导管抽吸。比较两组治疗效果、手术前后患侧-健侧大小腿周径差、凝血纤溶指标[血清D-二聚体(D-D)、纤维蛋白降解产物(FDP)、纤维蛋白原(FIB)]、血液流变学[血红蛋白(Hb)、红细胞平均体积(MCV)、红细胞压积(HCT)、血小板压积(PCT)],并对比两组术后血栓后综合征发生率。结果 观察组总有效率(94.12%比76.47%)、术中即时血栓清除率高于对照组,血栓抽吸时间[(292.26±61.48)s比(340.53±72.39)s]短于对照组(P<0.05);两组术后1 d、术后3 d患侧-健侧大腿周径差、患侧-健侧小腿周径差小于入院时,观察组小于对照组(P<0.05);术后1 d、术后3 d两组血清D-D、FDP、FIB低于入院时,观察组低于对照组(P<0.05);两组术后1 d、术后3 d Hb低于入院时,观察组高于对照组,MCV、PCT、HCT低于入院时,观察组低于对照组(P<0.05);两组术后3个月、6个月血栓后综合征发生率差异无统计学意义(P>0.05);观察组术后12个月血栓后综合征发生率低于对照组(12.50%比34.38%,P<0.05)。结论 溶栓药物经腘静脉置鞘预处理联合大腔导管抽吸治疗下肢深静脉血栓疗效显著,能明显缩短血栓抽吸时间,减轻患肢肿胀,改善凝血功能、血液流变学,降低术后血栓后综合征发生率。Objective To explore the clinical effect of thrombolytic drugs combined with large lumen catheter aspiration in the treatment of deep vein thrombosis of lower extremities.Methods A total of 68 patients with deep venous thrombosis of lower extremities in Jiaozuo Second People's Hospital from June 2018 to December 2020 were prospectively selected and grouped according to the random number table method,with 34 cases in each group.The control group was given large lumen catheter aspiration,while the study group was given thrombolytic drugs through the popliteal vein sheath preconditioning combined with large lumen catheter aspiration.The treatment effect,the difference in the circumference of the affected side and the contralateral leg before and after surgery,the coagulation and fibrinolysis indexes[serum D-dimer(DD),fibrin degradation product(FDP),fibrinogen(FIB)],Hemorheology[hemoglobin(Hb),mean corpuscular volume(MCV),hematocrit(HCT),platelet volume(PCT)],and the incidence of post-thrombotic syndrome between the two groups were compared.Results The total effective rate(94.12%vs.76.47%)and immediate intraoperative thrombus clearance rate in the study group were higher than those in the control group,and the thrombus aspiration time in the study group was shorter than that in the control group[(292.26±61.48)s vs.(340.53±72.39)s](P<0.05).The difference of calf circumference between the affected side and the unaffected side,and the circumferential diameter between the affected side and the unaffected side of the calf in the two groups after 1 day and 3 days after surgery were smaller than that at admission,and those in the study group were smaller than those of the control group(P<0.05).D-D,FDP and FIB in the two groups were lower than those at the time of admission 1 day and 3 days after the operation,those in the study group were lower than those in the control group(P<0.05);Hb in the two groups was lower than that at the time of admission 1 day and 3 days after the operation,the study group was higher than the c

关 键 词：静脉血栓形成 下肢 溶栓药物 腘静脉置鞘 预处理 大腔导管抽吸术 

分 类 号：R654.3[医药卫生—外科学]