目的 探讨超声引导下静脉穿刺联合AngioJet机械抽栓治疗急性下肢深静脉血栓形成(acute deep vein thrombosis of lower limbs,ADVT)的疗效.方法 选取2018年1月至2022年12月大庆龙南医院ADVT患者78例,将患者分为置管溶栓组和联合溶栓组,其中置管溶栓组行单纯置管溶栓,联合溶栓组行超声引导下静脉穿刺联合AngioJet机械抽栓治疗.分别采用Villalta量表和静脉登记指数(vein registration index,VRI)评估血栓后综合征和血栓清除率,比较治疗前后两组血栓后综合征得分、血栓清除率、患肢消肿率、D-二聚体(D-Dimer,DD),并比较两组治疗期尿激酶用量和治疗后并发症发生情况.结果 78例患者中,男41例、女37例;年龄42～59岁,平均(50.9±8.6)岁.与治疗前相比,治疗后两组各项血栓综合征得分、VRI和DD降低,且联合溶栓组低于置管溶栓组;治疗后联合溶栓组的血栓清除率、患肢消小腿、大腿消肿率高于置管溶栓组;治疗期联合溶栓组尿激酶用量低于置管溶栓组,差异均有统计学意义(P＜0.05);治疗后两组并发症发生率的比较,差异无统计学意义(P>0.05).结论 超声引导下静脉穿刺联合AngioJet机械抽栓可有效清除ADVT患者血栓、促进患肢消肿并预防血栓后综合征,改善血液凝结状态,并发症较少.
Clinical observation on ultrasound-guided venipuncture combined with AngioJet mechanical embolectomy for acute deep venous thrombosis of lower limbs
Objective To explore the therapeutic effect of ultrasound-guided venipuncture combined with AngioJet mechanical embolectomy on acute deep vein thrombosis of lower limbs(ADVT).Methods A total of 78 ADPT patients admitted in Daqing Longnan Hospital from January 2018 to December 2022 were selected,and were divided into catheter thrombolysis group and combined thrombolysis group.Patients in the catheter thrombolysis group received simple catheterization and thrombolysis,while patients in the combined thrombolysis group received ultrasound-guided venipuncture combined with AngioJet mechanical embolectomy.Villalta scale and vein registration index(VRI)were used to evaluate the post-thrombotic syndrome and thrombus clearance rate respectively.The scores of post-thrombotic syndrome,thrombus clearance rate,swelling rate of affected limb and D-dimer(DD)before and after treatment,while the dosage of urokinase during the treatment period and the incidence of complications after treatment were compared between the two groups.Results Among the 78 patients,there were 41 males and 37 females,aged from 42 to 59 years old,and the average age was(50.9±8.6)years.Compared with before treatment,the scores of thrombosis syndrome,VRI and DD were decreased after treatment in both groups,and the above indicators of the combined thrombolysis group were lower than those of the catheter thrombolysis group,and the differences were statistically significant(all P<0.05).After treatment,the thrombus clearance rate,swelling rate of affected thigh and crus of combined thrombolysis group were higher than those of catheter thrombolysis group,and the differences were statistically significant(all P<0.05).During the treatment period,the dosage of urokinase in the combined thrombolysis group was lower than that in the catheter thrombolysis group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of complications between the two groups after treatment(P＞0.05).Conclusions Ultrasound-guided venipuncture combined with AngioJet mechanical embolectomy can effectively remove thrombus in ADVT patients,promote detumescence of affected limbs,prevent post-thrombotic syndrome,and improve blood coagulation,with few complications.
acute deep vein thrombosis of lower limbs(ADVT)ultrasound-guided venipunctureAngioJet mechanical embolectomythrombolysis
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