血栓抽吸装置与单纯导管接触溶栓治疗下肢深静脉血栓合并髂静脉压迫综合征的临床价值  

Clinical value of thrombus aspiration device and pure catheter contact thrombolysis in the treatment of lower extremity deep vein thrombosis complicated with iliac vein compression syndrome

作　　者：张汝铭 闫金铭 Zhang Ruming;Yan Jinming(Department of Vascular Surgery,Shandong Provincial Third Hospital,Ji'nan 250000,Shandong,China;Department of Gastroenterology,Shandong Provincial Third Hospital,Ji'nan 250000,Shandong,China)

机构地区：[1]山东省立第三医院血管外科,山东济南250000 [2]山东省立第三医院消化内科,山东济南250000

出　　处：《血管与腔内血管外科杂志》2025年第3期360-364,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的探讨血栓抽吸装置与单纯导管接触溶栓(CDT)治疗下肢深静脉血栓(DVT)合并髂静脉压迫综合征(IVCS)的临床价值。方法收集2019年1月至2024年1月山东省立第三医院收治的110例DVT合并IVCS患者的临床资料,按照治疗方法的不同将其分为治疗组(n=60,采用Acostream血栓抽吸装置治疗,必要时使用CDT治疗)与对照组(n=50,单纯采用CDT治疗)。比较两组患者围手术期指标、溶栓有效清除率、大腿及小腿周径差、下肢静脉临床严重程度评分(VCSS)、深静脉血栓形成后综合征(PTS)发生风险、并发症发生率及DVT复发率。结果治疗后,治疗组患者溶栓时间、住院时间均短于对照组患者,尿激酶用量少于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后,治疗组患者溶栓清除有效率为95.00%,高于对照组患者的62.00%,差异有统计学意义(P﹤0.05)。治疗后,两组患者大腿周径差、小腿周径差均低于本组治疗前,且治疗组患者均低于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后,两组患者VCSS、Villalta评分均低于本组治疗前,且治疗组患者VCSS、Villalta评分均低于对照组患者,差异均有统计学意义(P﹤0.05)。治疗组患者并发症总发生率为3.33%,低于对照组患者的16.00%,差异有统计学意义(P﹤0.05)。随访6个月,两组患者DVT复发率比较,差异无统计学意义(P﹥0.05)。结论与单纯CDT治疗相比,Acostream血栓抽吸装置治疗DVT合并IVCS患者,能缩短溶栓时间、住院时间,降低尿激酶用量,提高血栓清除率,消除患肢肿胀,缓解病情,减少PTS发生风险,降低并发症发生率,且DVT复发率少。Objective To explore the clinical value of thrombus aspiration device and simple catheter contact thrombolysis(CDT)in the treatment of lower extremity deep vein thrombosis(DVT)combined with iliac vein compression syndrome(IVCS).Method Clinical data of 110 patients with DVT combined with IVCS admitted to the Shandong Provincial Third Hospital from January 2019 to January 2024 were collected,they were divided into treatment group(n=60,treated with Acostrem thrombus aspiration device,and if necessary,treated with CDT)and control group(n=50,treated with CDT alone)according to different treatment methods.The perioperative indicators,thrombolysis effective clearance rate,thigh and calf circumference difference,lower extremity venous clinical severity score(VCSS),risk of post-thrombotic syndrome(PTS)occurrence,incidence of complications,and recurrence rate of DVT between two groups of patients were compared.Result After treatment,the thrombolysis time and hospitalization time of the treatment group patients were shorter than those of the control group patients,and the dosage of urokinase was less than that of the control group patients,with statistically significant differences(P<0.05).After treatment,the effective rate of thrombolysis clearance in the treatment group was 95.00%,higher than that in the control group of 62.00%,the difference was statistically significant(P<0.05).After treatment,the difference in thigh circumference and calf circumference between the two groups of patients were lower than their before treatment,and the treatment group was lower than the control group,with statistically significant differences(P<0.05).After treatment,the VCSS and Villalta scores of both groups of patients were lower than their before treatment,and the VCSS and Villalta scores of the treatment group were lower than their of the control group,with statistical significance(P<0.05).The total incidence of complications in the treatment group was 3.33%,lower than the 16.00%in the control group,the difference was statistically si

关 键 词：下肢深静脉血栓 髂静脉压迫综合征 单纯导管接触溶栓 

分 类 号：R543[医药卫生—心血管疾病]