经皮机械性血栓清除术治疗急性下肢深静脉血栓合并髂静脉压迫综合征的临床疗效观察  

Clinical efficacy of percutaneous mechanical thrombus removal in the treatment of acute deep vein thrombosis of lower extremity complicated with iliac vein compression syndrome

作　　者：章安伟 魏森 黄林晨 赵琪 朱海潮 朱健 Zhang Anwei;Wei Sen;Huang Linchen;Zhao Qi;Zhu Haichao;Zhu Jian(Department of Vascular Surgery,the First People's Hospital of Kunshan,Kunshan 215300,Jiangsu,China)

机构地区：[1]昆山市第一人民医院血管外科,江苏昆山215300

出　　处：《血管与腔内血管外科杂志》2024年第6期650-654,共5页Journal of Vascular and Endovascular Surgery

基　　金：2022年度省卫健委医学科研项目指导性课题(Z2022096)。

摘　　要：目的探讨经皮机械性血栓清除术治疗急性下肢深静脉血栓(DVT)合并髂静脉压迫综合征的疗效及预后。方法收集2019年1月至2020年8月昆山市第一人民医院收治的62例急性下肢DVT合并髂静脉压迫综合征患者的临床资料,按照治疗方案的不同分为治疗组(在下腔静脉滤器保护下行经皮机械性血栓清除术+CDT治疗,同期行髂静脉狭窄腔内球囊扩张成形及支架置入术)和对照组(在下腔静脉滤器保护下行CDT治疗,同期行髂静脉狭窄腔内球囊扩张成形及支架置入术),每组31例。比较两组患者的尿激酶用量、溶栓时间、住院时间、溶栓管造影次数、血栓清除率、消肿程度、静脉临床严重程度评分法(VCSS)评分及血栓后综合征(PTS)发生率。结果治疗组患者的尿激酶用量明显低于对照组患者,血栓清除率明显高于对照组患者,溶栓时间、住院时间均明显短于对照组患者,溶栓管造影次数明显少于对照组患者,差异均有统计学意义(P﹤0.01)。治疗后,治疗组患者的大腿周径差、小腿周径差均小于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后6个月,治疗组患者的VCSS评分和Villata评分﹥4分的患者比例均低于对照组患者,差异均有统计学意义(P﹤0.05)。结论经皮机械性血栓清除术+CDT治疗+腔内球囊扩张成形及支架置入术治疗急性下肢DVT合并髂静脉压迫综合征的疗效显著,患者预后较好。Objective To investigate the efficacy and prognosis of percutaneous mechanical thrombectomy in the treatment of acute deep vein thrombosis(DVT)of lower extremity complicated with iliac vein compression syndrome.Method The clinical data of 62 patients with acute DVT of lower extremity complicated with iliac vein compression syndrome admitted to the First People's Hospital of Kunshan from January 2019 to August 2020 were collected.The patients were divided into treatment group(percutaneous mechanical thrombectomy+CDT treatment under inferior vena cava filter protection,concurrent endovascular balloon dilation and stent implantation for iliac vein stenosis)and control group(CDT treatment under inferior vena cava filter protection,concurrent endovascular balloon dilation and stent implantation for iliac vein stenosis),with 31 cases in each group.The urokinase dosage,thrombolytic duration,hospitalization time,number of thrombolytic tube angiography,thrombus clearance rate,detumescence degree,venous clinical severity score(VCSS),and incidence of post thrombosis syndrome(PTS)were compared between the two groups.Result The dosage of urokinase in the treatment group was significantly lower than that in the control group,and the thrombus clearance rate was significantly higher than that in the control group,the thrombolysis duration and hospitalization time were significantly shorter than those in the control group,the number of thrombolytic tube angiography was significantly less than that in the control group,and the differences were statistically significant(P<0.01).After treatment,the difference in thigh circumference and calf circumference in the treatment group were smaller than those in the control group,and the differences were statistically significant(P<0.05).After 6 months of treatment,the VCSS score and the proportion of patients with Villata score>4 in the treatment group were lower than those of patients in the control group,and the differences were statistically significant(P<0.05).Conclusion The percutaneou

关 键 词：经皮机械性血栓清除术 导管接触性溶栓 深静脉血栓 髂静脉压迫综合征 临床疗效 

分 类 号：R543[医药卫生—心血管疾病]