CDT联合支架置入与系统溶栓治疗IVCS合并下肢DVT的效果及安全性对比  

Comparison of Effect and Safety of CDT Combined with Stent Implantation and System Thrombolysis in the Treatment of IVCS with Lower Extremity DVT

作　　者：曾三平 曾志峰 黎焕 聂胜峰 ZENG Sanping;ZENG Zhifeng;LI Huan;NIE Shengfeng(Department of Hepatobiliary Surgery,Xinyu People's Hospital,Xinyu 338000,China;不详)

机构地区：[1]新余市人民医院肝胆外科,江西新余338000

出　　处：《中国医学创新》2024年第11期5-9,共5页Medical Innovation of China

基　　金：新余市科技计划项目(20213090828)。

摘　　要：目的:探究并对比导管接触性溶栓(CDT)联合支架置入与系统溶栓治疗髂静脉受压综合征(IVCS)合并下肢深静脉血栓(DVT)的效果及安全性。方法:选取新余市人民医院2020年6月—2022年6月收治的70例IVCS合并下肢DVT患者作为研究对象,采用随机数字表法分为非手术组和手术组,各35例。非手术组患者给予系统溶栓治疗,手术组患者给予CDT联合支架置入治疗。观察并比较两组患者凝血指标[D-二聚体(D-D)、组织型纤溶酶原激活物(t-PA)、凝血酶原时间(PT)];静脉阻塞情况(阻塞评分、溶栓率、静脉通畅率);水肿情况(患肢围径差、消肿率);治疗期间住院情况(住院天数、住院费用);预后效果[继发性下肢深静脉瓣膜功能不全、下肢深静脉血栓后遗症(PTS)]。结果:治疗5 d后,手术组患者D-D水平低于非手术组,t-PA水平高于非手术组,PT长于非手术组(P<0.05)。治疗3个月后,手术组患者阻塞评分低于非手术组(P<0.05);手术组患者溶栓率、静脉通畅率均高于非手术组(P<0.05)。治疗3个月后,手术组患者膝上、膝下腿围径差均小于非手术组(P<0.05);手术组患者膝上、膝下消肿率均高于非手术组(P<0.05)。手术组患者住院天数少于非手术组(P<0.05)。手术组患者继发性下肢深静脉瓣膜功能不全发生率及PTS发生率均低于非手术组(P<0.05)。结论:CDT联合支架置入治疗用于IVCS合并下肢DVT患者可改善其临床症状,治疗效果较常规系统溶栓治疗更佳,且治疗后恢复更快,预后更为理想。Objective:To explore and compare the effect and safety of catheter-directed thrombolysis(CDT)combined with stent implantation and system thrombolysis in the treatment of iliac vein compression syndrome(IVCS)with deep venous thrombosis(DVT)of lower extremities.Method:A total of 70 patients with IVCS complicated with lower extremity DVT admitted to Xinyu People's Hospital from June 2020 to June 2022 were selected as the study subjects,and they were divided into non-surgical group and surgical group by random number table method with 35 cases in each group.The non-surgical group was treated with system thrombolysis,and the surgical group was given CDT combined with stent implantation.The coagulation indicators[D-dimer(D-D),tissue plasminogen activator(t-PA),prothrombin time(PT)],venous obstruction(obstruction score,thrombolysis rate,venous patency rate)and edema(circumference difference of affected limb,detumescence rate)and hospitalization during treatment(hospital stay,hospitalization cost)and prognosis[secondary lower extremity deep venous valve insufficiency,post-thrombotic syndrome(PTS)]were observed and compared between the two groups of patients.Result:After 5 d of treatment,the D-D level in the surgical group was lower than that in the non-surgical group,the t-PA level was higher than that in the non-surgical group group,and the PT was longer than that in the non-surgical group group(P<0.05).After 3 months of treatment,the obstruction score of the surgical group was lower than that of the non-surgical group(P<0.05);the thrombolysis rate and venous patency rate in surgical group were higher than those in non-surgical group(P<0.05).After 3 months of treatment,circumference differences of upper knee and lower knee of affected limb in the surgical group were smaller than those in the non-surgical group(P<0.05);the swelling reduction rate above and below the knee in surgical group were higher than those in non-surgical group(P<0.05).The number of days in hospital in surgical group was less than that in non-surgic

关 键 词：导管接触性溶栓 支架置入 系统溶栓 髂静脉受压综合征 下肢深静脉血栓 安全性 

分 类 号：R654.4[医药卫生—外科学]