球囊扩张联合导管接触溶栓治疗下肢深静脉血栓形成的效果  

The effect of balloon dilation combined with catheter-directed thrombolysis on deep venous thrombosis of the lower extremities

作　　者：欧明旭 徐江 汪丹青[2] 金良 王筝 胡杨刚 周固超[2] 王良斌 OU Mingxu;XU Jiang;WANG Danqing;JIN Liang;WANG Zheng;HU Yanggang;ZHOU Guchao;WANG Liangbin(Graduate School of Bengbu Medical University,Bengbu 233030,China;不详)

机构地区：[1]蚌埠医科大学研究生院,蚌埠233030 [2]铜陵市人民医院普外科血管病区

出　　处：《中国临床保健杂志》2024年第3期319-322,共4页Chinese Journal of Clinical Healthcare

基　　金：蚌埠医学院自然科学重点项目(2023byzd057)。

摘　　要：目的探讨球囊扩张联合导管接触溶栓(CDT)治疗下肢深静脉血栓形成(DVT)的效果。方法回顾性分析2017年11月至2023年12月于铜陵市人民医院血管外科诊断为DVT且接受CDT治疗的41例患者病历资料。根据术中是否采用球囊扩张分为观察组(球囊扩张联合CDT,20例)和对照组(单纯CDT,21例),比较2组患者的尿激酶用量、溶栓时间、住院时间、手术结束至复查纤维蛋白原达最低值所需时间、溶栓成功率、血栓清除时间、Villalta评分、纤维蛋白原变化量与静脉通畅率的相关性、消肿率。结果与对照组相比,观察组血栓清除时间更短[3(1,5)月比5(3,8)月,P<0.05]。在住院时间、尿激酶用量、溶栓时间上,观察组要明显少于对照组(P<0.05),手术结束至复查纤维蛋白原达最低值所需时间明显短于对照组[(15.45±8.14)h比(21.71±9.95)h,P<0.05]。观察组中,纤维蛋白原变化量与静脉通畅率存在线性相关关系。结论在DVT的治疗中,球囊扩张联合CDT较单纯CDT有更好的溶栓效果和更低的出血风险。Objective To explore the effect of balloon dilation combined with catheter-directed thrombolysis(CDT)in the treatment of deep venous thrombosis(DVT)of the lower extremities.Methods The clinical data of 41 patients with DVT who received CDT treatment in the department of vascular surgery,Tongling People′s Hospital from November 2017 to December 2023 were retrospectively analyzed.According to whether balloon dilatation was used during the operation,the patients were divided into the observation group(balloon dilatation combined with CDT,n=20)and the control group(CDT alone,n=21).The differences in the efficacy of the two groups were evaluated by comparing the amounts of urokinase used,thrombolysis time,hospitalization days,time to peak fibrinogen decline,thrombolysis success rate,thrombus removal time,Villalta score,changes in fibrinogen and venous patency,anddema resolution rate.Results Compared with CDT alone,balloon dilatation combined with CDT had a shorter thrombus removal time[3(1,5)months vs 5(3,8)months],P<0.05.In terms of hospitalization time,urokinase dosage,and thrombolysis time,balloon dilatation combined with CDT were significantly lower than those of CDT alone,P<0.05,and the time to reach the peak decrease in fibrinogen was significantly shorter than that of CDT alone[(15.45±8.14)h vs(21.71±9.95)h,P<0.05].During the observation group,there was a linear relationship between the change of fibrinogen and the venous patency rate.Conclusion The combination of balloon dilation and CDT has better thrombolysis efficiency and lower bleeding risk than CDT alone in the treatment of DVT.

关 键 词：静脉血栓形成 血栓溶解疗法 血管成形术 气囊 冠状动脉 尿激酶型纤溶酶原激活物 

分 类 号：R654.4[医药卫生—外科学]