系统溶栓与综合介入治疗中老年急性混合型下肢深静脉血栓的效果观察  

Effect observation of systemic thrombolysis and comprehensive interventional therapy on middle aged and elderly patients with acute mixed deep venous thrombosis of the lower extremity

作　　者：刘伟 LIU Wei(First People's Hospital of Pingyuan County,Dezhou 253100,China)

机构地区：[1]平原县第一人民医院,253100

出　　处：《中国现代药物应用》2023年第10期24-28,共5页Chinese Journal of Modern Drug Application

摘　　要：目的 观察系统溶栓与综合介入治疗中老年急性混合型下肢深静脉血栓的效果。方法 76例中老年急性混合型下肢深静脉血栓患者,以随机数字表法分为观察组与对照组,各38例。对照组采取系统溶栓治疗,观察组采取综合介入治疗。比较两组治疗前后的下肢静脉通畅情况、肢体消肿情况、凝血功能指标、血流动力学指标、血栓总清除率。结果 治疗后,两组下腔静脉、股总静脉、股浅静脉上段、股浅静脉下段、髂总静脉、髂外静脉、腘静脉通畅评分均低于本组治疗前,且观察组下腔静脉通畅评分(1.65±0.25)分、股总静脉通畅评分(2.21±0.82)分、股浅静脉上段通畅评分(1.65±0.55)分、股浅静脉下段通畅评分(1.17±0.22)分、髂总静脉通畅评分(2.01±1.32)分、髂外静脉通畅评分(0.92±0.27)分、腘静脉通畅评分(1.55±0.69)分均低于对照组的(3.82±1.02)、(5.16±1.96)、(3.91±1.20)、(2.76±0.46)、(5.65±0.91)、(2.12±0.55)、(3.41±1.07)分,差异有统计学意义(P<0.05)。治疗后,两组小腿周径差、大腿周径差均小于本组治疗前,且观察组小腿周径差(1.23±0.11)cm、大腿周径差(1.76±0.53)cm小于对照组的(2.77±0.58)、(1.89±0.78)cm,小腿消肿率89.47%、大腿消肿率94.74%高于对照组的71.05%、65.79%,差异均有统计学意义(P<0.05)。治疗后,两组患者血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)长于本组治疗前,纤维蛋白原(Fib)低于本组治疗前,且观察组PT(12.26±1.66)s、APTT(32.76±5.31)s长于对照组的(10.31±1.71)、(29.47±3.66)s,Fib(3.03±1.22)g/L低于对照组的(4.35±1.46)g/L,差异均有统计学意义(P<0.05)。治疗后,两组血流峰速度(Vp)、血流平均速度(Va)、血流量(BF)均高于本组治疗前,且观察组Vp(70.78±3.15)cm/s、Va(45.12±3.82)cm/s、BF(2.36±0.55)L/min均高于对照组的(62.98±3.02)cm/s、(36.91±3.96)cm/s、(1.79±0.27)L/min,差异有统计学意义(P<0.05)。观察组血栓总清�Objective To observe the effect of systemic thrombolysis and comprehensive interventional therapy on middle aged and elderly patients with acute mixed deep venous thrombosis of the lower extremity.Methods A total of 76 cases of middle-aged and elderly patients with acute mixed deep venous thrombosis of the lower extremity were randomly divided into observation group and control group,with 38 cases in each group.The control group received systemic thrombolytic therapy,and the observation group received comprehensive interventional therapy.The patency of lower limb veins,detumescence of limbs,coagulation function index,hemodynamic index before and after treatment,and total thrombus clearance rate were compared between the two groups.Results After treatment,the patency scores of inferior vena cava,common femoral vein,upper segment of superficial femoral vein,lower segment of superficial femoral vein,common iliac vein,external iliac vein,and popliteal vein in both groups were lower than those before treatment in this group;the patency scores of inferior vena cava,common femoral vein,upper segment of superficial femoral vein,lower segment of superficial femoral vein,common iliac vein,external iliac vein,and popliteal vein were(1.65±0.25),(2.21±0.82),(1.65±0.55),(1.17±0.22),(2.01±1.32),(0.92±0.27),and(1.55±0.69)points in the observation group,which were lower than those of(3.82±1.02),(5.16±1.96),(3.91±1.20),(2.76±0.46),(5.65±0.91),(2.12±0.55),and(3.41±1.07)points in the control group;the differences were statistically significant(P<0.05).After treatment,the difference in calf circumference and difference in thigh circumference in two groups were less than those before treatment in this group;the difference in calf circumference of(1.23±0.11)cm and difference in thigh circumference of(1.76±0.53)cm in the observation group were smaller than those of(2.77±0.58)and(1.89±0.78)cm in the control group;the deswelling rates of calf and thigh in the observation group were 89.47%and 94.74%,which were higher than

关 键 词：系统溶栓 综合介入 急性混合型下肢深静脉血栓 中老年 疗效 

分 类 号：R543.6[医药卫生—心血管疾病]