首页|个体化溶栓辅助下综合介入治疗下肢深静脉血栓的临床研究

个体化溶栓辅助下综合介入治疗下肢深静脉血栓的临床研究

Individualized thrombolysis-assisted comprehensive intervention for deep vein thrombosis in the lower limbs

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目的 评价个体化溶栓辅助下综合介入治疗下肢深静脉血栓的临床效果.方法 选取2012年3月至2021年11月扬州大学建湖临床医学院收治的造影诊断为急性下肢深静脉血栓患者32例,先置入下腔静脉滤器,再根据治疗方法不同分为两组:对照组置入溶栓导管,常规滴注尿激酶;观察组先行球囊扩张、大腔导管抽吸血栓,再置入溶栓导管,尿激酶剂量根据纤维蛋白原测值而定.对两组患肢消肿情况、静脉通畅度及并发症等进行观察比较.结果 对照组治疗前大腿周径差为(4.65±1.06)cm,治疗后大腿周径差为(2.76±1.25)cm;观察组治疗前大腿周径差为(4.73±1.03)cm,治疗后大腿周径差为(1.40±0.83)cm;对照组治疗前小腿周径差为(2.24±0.90)cm,治疗后小腿周径差为(1.56±0.86)cm;观察组治疗前小腿周径差为(2.40±0.83)cm,治疗后小腿周径差为(0.80±0.73)cm,两组治疗后健侧与患侧大腿周径差、健侧与患侧小腿周经差,差异均有统计学意义(t=3.58、2.67,均P<0.05).治疗后对照组静脉通畅度为34.02%[33/97],而观察组静脉通畅度为68.18%[60/88],差异有统计学意义(t=3.44,P<0.05).随访12个月后对照组血栓后综合征(PTS)Villalta评分为(9.23±4.07)分,观察组PTS Villalta评分为(5.73±3.39)分,两组差异有统计学意义(t=2.62,P<0.05).结论 个体化溶栓辅助下综合介入治疗下肢深静脉血栓的临床效果明显,且并发症少.
Objective To evaluate the clinical efficacy of individualized thrombolysis-assisted comprehensive intervention for deep vein thrombosis(DVT)in the lower limbs.Methods This study included 32 patients withacute lower limb DVT diagnosed by angiography who received treatment at the Jianhu Clinical Medical College of Yangzhou University from March 2012 to November 2021.These patients first received implantation of an inferior vena cava filter.Then they were divided into a control group and an observation group based on treatment methods.The control group received thrombolytic catheterization and a routine infusion of urokinase.In the observation group,balloon dilation was performed first,and a large lumen catheter was used to draw blood clots.Subsequently,urokinase at a dose based on fibrinogen measurement was injected through a thrombolytic catheter.Swelling reduction,venous patency,and complications of the affected limbs were monitored.Results In the control group,the difference in thigh circumference before treatment was(4.65±1.06)cm,and after treatment,it was(2.76± 1.25)cm.In the observation group,the difference in thigh circumference before treatment was(4.73± 1.03)cm,and it was(1.40±0.83)cm after treatment.In the control group,the difference in calf circumference before treatment was(2.24±0.90)cm,and it was(1.56±0.86)cm after treatment.In the observation group,the difference in calf circumference before treatment was(2.40±0.83)cm,and it was(0.80±0.73)cm after treatment.After treatment,the differences in thigh circumference and calf circumference between the healthy and affected sides were statistically significant(t=3.58,2.67,both P<0.05).After treatment,there was a significant difference in venous patency between the control and observation groups(34.02%[33/97]vs.68.18%[60/88],t=3.44,P<0.05).After 12 months of follow-up,the Villalta scale score,which was used to evaluate post-thrombotic syndrome,was(9.23±4.07)points in the control group,which was significantly different from(5.73±3.39)points in the observation group(t=2.62,P<0.05).Conclusion Individualized thrombolysis-assisted comprehensive intervention is highly effective in the treatment of DVT in the lower limbs and results in few complications.

Venous thrombosisLower extremityBalloon embolectomyThrombolytic therapyVena cava filtersFibrinogenPostthrombotic syndromeCombined modality therapy

岳天华、袁鹏、陈法警、沈酥雯、王建、邢伟

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扬州大学建湖临床医学院介入科,盐城 224700

苏州大学第三临床医学院影像科,常州 213000

静脉血栓形成 下肢 球囊取栓术 血栓溶解疗法 腔静脉滤器 纤维蛋白原 血栓形成后综合征 综合疗法

2024

中国基层医药
中华医学会,安徽医科大学

中国基层医药

影响因子:1.003
ISSN:1008-6706
年,卷(期):2024.31(1)
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