活血通脉片辅助介入治疗恶性肿瘤引起髂股静脉受压重度狭窄继发下肢深静脉血栓患者的效果  

Effect of Huoxue Tongmai Tablets Assisted Interventional Therapy on Patients with Deep Venous Thrombosis of Lower Extremity Secondary to Severe Stenosis of Iliofemoral Vein Caused by Malignant Tumor

作　　者：陈琛 姚阳端 赵石垒 CHEN Chen;YAO Yangduan;ZHAO Shilei(Department of Vascular Surgery,Luminghu Hospital of Xuchang Central Hospital,Xuchang 461000,Henan,China)

机构地区：[1]许昌市中心医院鹿鸣湖院区血管外科,河南许昌461000

出　　处：《中国药物滥用防治杂志》2024年第12期2315-2316,2321,共3页Chinese Journal of Drug Abuse Prevention and Treatment

摘　　要：目的:分析恶性肿瘤引起髂股静脉受压重度狭窄继发下肢深静脉血栓形成的介入术后联合活血通脉片治疗的有效性。方法:选取2021年1月—2022年8月我院收治的40例因恶性肿瘤引起髂股静脉受压重度狭窄继发下肢深静脉血栓患者,所有患者均接受介入治疗和活血通脉片联合治疗,分析患者治疗前后患肢消肿情况、血栓清除率及并发症发生率。结果:40例患者共植入Wallstent、Smart髂静脉支架、Aegisy可回收滤器、Celect可回收滤器43枚,植入率为77.50%,滤器取出率为61.29%,7枚滤器在取出后有脱落血栓。术后患者大腿周径差、小腿周径差均比术前低(P<0.05);平均血栓清除率为(85.32±9.06)%,血栓清除评级中10例为Ⅲ级,20例为Ⅱ级,治疗后随访一期通畅率达到100%,二期通畅率为100%,其中5例支架内出现再次狭窄情况,经过处理后恢复通畅;40例患者中2个月后1例患者侧肢体肿胀,经过介入治疗,随访6个月患者病情没有复发。1例患者髂股静脉破裂出血,经过植入覆膜支架处理,血流恢复通畅,并发症发生率为5.00%。结论:对于恶性肿瘤引起髂股静脉受压重度狭窄继发下肢深静脉血栓形成患者,采取介入术联合活血通脉片进行治疗的有效性、安全性高,值得临床应用。Objective:To analyze the effectiveness of interventional therapy combined with Huoxue Tongmai Tablets in the treatment of deep venous thrombosis of lower extremity secondary to severe iliac femoral vein compression stenosis caused by malignant tumor.Methods:From January 2021 to August 2022,40patients with deep venous thrombosis of lower extremity secondary to severe stenosis of iliac femoral vein compression caused by malignant tumor were selected.All patients received interventional therapy and Huoxue Tongmai tablets.The swelling of the affected limb before and after treatment,thrombus clearance rate and complication rate were analyzed.Results:A total of 40 patients were implanted with Wallstent,Smart iliac vein stent,Aegisy retrievable filter,and Celect retrievable filter(n=43),the implantation rate was 77.50%,the filter removal rate was 61.29%,and 7 filters had shedding thrombus after removal.The thigh circumference difference and calf circumference difference of patients after operation were lower than those before operation(P<0.05).The average thrombus clearance rate was(85.32±9.06)%.Among the thrombus clearance rating,10 cases were gradeⅢand 20 cases were gradeⅡ.After treatment,the primary patency rate was 100%and the secondary patency rate was 100%.Among them,5 cases had restenosis in the stent,which was restored after treatment.Among the 40 patients,1 patient had swelling of the lateral limbs after 2 months.After interventional therapy,there was no recurrence of the disease after 6 months of followup.One patient suffered from iliofemoral vein rupture and bleeding.After implantation of covered stent,the blood flow was restored to patency,and the incidence of complications was 5.00%.Conclusion:Interventional therapy combined with Huoxue Tongmai Tablets is effective and safe in the treatment of lower extremity deep venous thrombosis secondary to severe iliac femoral vein compression stenosis caused by malignant tumors,which is worthy of clinical application.

关 键 词：恶性肿瘤 髂股静脉 受压 重度狭窄 下肢深静脉血栓 活血通脉片 

分 类 号：R47[医药卫生—护理学]