血栓抽吸导管在治疗下肢深静脉血栓形成中的应用  

Application of thrombus aspiration catheter in the treatment of deep venous thrombosis of lower extremity

作　　者：尹月蕾 段友良 卢军峰 周冠洲 赵呈祥 吴书圣 Yin Yuelei;Duan Youliang;Lu Junfeng;Zhou Guanzhou;Zhao Chengxiang;Wu Shusheng(Department of Vascular Surgery,Shandong Provincial Third Hospital,Ji'nan 250031,Shandong,China)

机构地区：[1]山东省立第三医院血管外科,山东济南250031

出　　处：《血管与腔内血管外科杂志》2024年第10期1172-1174,1215,共4页Journal of Vascular and Endovascular Surgery

基　　金：山东省医药卫生科技发展计划(2017WS791)。

摘　　要：目的探讨血栓抽吸导管在治疗下肢深静脉血栓形成(DVT)中的应用效果。方法收集2022年9月至2023年2月于山东省立第三医院使用血栓抽吸导管进行治疗的37例下肢DVT患者的临床资料,观察出血情况、血红蛋白变化情况、肝肾功能及凝血功能,评估血栓清除效果、新发血栓和支架内再狭窄发生情况。结果37例下肢DVT患的手术成功率为100%,其中,13例进行一期髂静脉支架植入术,6例进行球囊扩张成形术。1例因脑出血术后未行尿激酶溶栓治疗,其余患者术后均留置血管鞘进行尿激酶溶栓治疗。37例术后均未发生出血不良事件,术后72 h内均无肝肾功能损伤;术后膝关节上20 cm处腿围、膝关节下10 cm处腿围、血红蛋白水平均明显小于术前(P﹤0.01)。结论使用血栓抽吸导管治疗下肢DVT安全、有效,术后联合尿激酶进行溶栓治疗可增加血栓清除效果。Objective To explore the application effect of thrombus aspiration catheter in the treatment of deep venous thrombosis(DVT)of lower extremity.Method Clinical data of 37 patients with DVT of lower extremities treated with thrombus aspiration catheter at Shandong Provincial Third Hospital from September 2022 to February 2023 were collected.The patient's bleeding situation,hemoglobin changes,liver and kidney function,coagulation function were observed,and the effectiveness of thrombus clearance,the presence of new thrombosis,the occurrence of in stent restenosis were evaluated.Result The success rate of surgery for 37 patients with lower extremities DVT was 100%.Among the 37 patients,13 underwent primary iliac vein stent implantation,while 6 patients of the remaining patients underwent balloon angioplasty.One patient did not receive urokinase thrombolysis treatment after surgery due to cerebral hemorrhage,while the remaining 36 patients underwent urokinase thrombolysis treatment with indwelling vascular sheaths after surgery.A total of 37 patients did not experience any adverse bleeding events after surgery,and there was no liver or kidney function damage within 72 h after surgery;the leg circumference at 20 cm above the knee joint,10 cm below the knee joint and the hemoglobin level after surgery were significantly smaller than before surgery,the differences were statistically significant(P<0.01).Conclusion The thrombus aspiration catheter is safe and effective in the treatment of lower extremity DVT,and postoperative thrombolysis combined with urokinase can increase the effect of thrombus removal.

关 键 词：下肢深静脉血栓形成 血栓抽吸导管 机械血栓抽吸 

分 类 号：R543[医药卫生—心血管疾病]