中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
1期
28-30
,共3页
徐贵云%蒋厚文%郝立俊%陈闯
徐貴雲%蔣厚文%郝立俊%陳闖
서귀운%장후문%학립준%진틈
静脉血栓形成%抗凝药%导管消融术%腘静脉%腔静脉滤器
靜脈血栓形成%抗凝藥%導管消融術%腘靜脈%腔靜脈濾器
정맥혈전형성%항응약%도관소융술%객정맥%강정맥려기
Venous thrombosis%Anticoagulants%Catheter ablation%Popliteal vein%Vena cava filters
目的 探讨经腘静脉置入溶栓导管持续灌注溶栓药物治疗急性下肢深静脉血栓形成(deep venous thrombosis,DVT)的临床应用价值.方法 本组32例急性DVT患者(其中3例合并肺动脉栓塞),男15例,女17例,年龄18 ～71岁,平均(51±17)岁.在超声引导下经患肢腘静脉穿刺置入溶栓导管至髂、股静脉血栓中进行溶栓治疗,并对溶栓效果进行分析.结果 全组患者溶栓后症状明显改善,下肢肿胀消退,肺部症状缓解.溶栓后患、健侧大腿周径差为(1.7±1.3)cm,明显小于溶栓前(5.4±1.4)cm,两者相比差异有统计学意义(t=9.92,P＜0.01).患肢大腿消肿率为91.74％；溶栓后患、健侧小腿周径差为(1.5±0.7)cm,明显小于溶栓前(4.1±1.5)cm(t =7.65,P＜0.01).患肢小腿消肿率为86.02％.溶栓前静脉通畅评分(15±4)分,明显高于溶栓后(4±3)分(t=7.12,P＜0.01),溶栓后静脉平均通畅率为88.21％.3例合并肺动脉栓塞患者1例栓子完全溶解,2例大部分溶解.所有患者均无严重并发症.29例患者获随访,随访3 ～ 12个月,平均(7.8±2.4)个月.无一例出现血栓再发.结论 经腘静脉置管溶栓治疗急性DVT是一种安全、有效的治疗方法.
目的 探討經腘靜脈置入溶栓導管持續灌註溶栓藥物治療急性下肢深靜脈血栓形成(deep venous thrombosis,DVT)的臨床應用價值.方法 本組32例急性DVT患者(其中3例閤併肺動脈栓塞),男15例,女17例,年齡18 ～71歲,平均(51±17)歲.在超聲引導下經患肢腘靜脈穿刺置入溶栓導管至髂、股靜脈血栓中進行溶栓治療,併對溶栓效果進行分析.結果 全組患者溶栓後癥狀明顯改善,下肢腫脹消退,肺部癥狀緩解.溶栓後患、健側大腿週徑差為(1.7±1.3)cm,明顯小于溶栓前(5.4±1.4)cm,兩者相比差異有統計學意義(t=9.92,P＜0.01).患肢大腿消腫率為91.74％；溶栓後患、健側小腿週徑差為(1.5±0.7)cm,明顯小于溶栓前(4.1±1.5)cm(t =7.65,P＜0.01).患肢小腿消腫率為86.02％.溶栓前靜脈通暢評分(15±4)分,明顯高于溶栓後(4±3)分(t=7.12,P＜0.01),溶栓後靜脈平均通暢率為88.21％.3例閤併肺動脈栓塞患者1例栓子完全溶解,2例大部分溶解.所有患者均無嚴重併髮癥.29例患者穫隨訪,隨訪3 ～ 12箇月,平均(7.8±2.4)箇月.無一例齣現血栓再髮.結論 經腘靜脈置管溶栓治療急性DVT是一種安全、有效的治療方法.
목적 탐토경객정맥치입용전도관지속관주용전약물치료급성하지심정맥혈전형성(deep venous thrombosis,DVT)적림상응용개치.방법 본조32례급성DVT환자(기중3례합병폐동맥전새),남15례,녀17례,년령18 ～71세,평균(51±17)세.재초성인도하경환지객정맥천자치입용전도관지가、고정맥혈전중진행용전치료,병대용전효과진행분석.결과 전조환자용전후증상명현개선,하지종창소퇴,폐부증상완해.용전후환、건측대퇴주경차위(1.7±1.3)cm,명현소우용전전(5.4±1.4)cm,량자상비차이유통계학의의(t=9.92,P＜0.01).환지대퇴소종솔위91.74％；용전후환、건측소퇴주경차위(1.5±0.7)cm,명현소우용전전(4.1±1.5)cm(t =7.65,P＜0.01).환지소퇴소종솔위86.02％.용전전정맥통창평분(15±4)분,명현고우용전후(4±3)분(t=7.12,P＜0.01),용전후정맥평균통창솔위88.21％.3례합병폐동맥전새환자1례전자완전용해,2례대부분용해.소유환자균무엄중병발증.29례환자획수방,수방3 ～ 12개월,평균(7.8±2.4)개월.무일례출현혈전재발.결론 경객정맥치관용전치료급성DVT시일충안전、유효적치료방법.
Objective To evaluate catheter-directed thrombolysis via the popliteal vein in the treatment of the lower limb acute deep venous thrombosis.Methods From July 2009 to October 2010,32patients of the lower limb acute deep venous thrombosis including 3 patients with concurrent pulmonary embolism underwent uhrasound-guided catheter-directed thrombolysis via the popliteal vein.The thrombolytic catheter was inserted into thrombus,through which urokinase was infused at a dosage of 100 × 104U/d.The venous patency score and the rate of patency improvement were observed by venograms before and after therapy.Results In every patient,the lower limb swell and pulomonary symptoms relieved.The circumferences between affected and normal thigh before and after the thrombolysis were(5.4 ± 1.4)cm and (1.7 ± 1.3)cm(t =9.92,P ＜0.01).The circumferences between affected and normal leg before and after the thrombolysis were(4.1 ± 1.5)cm and(1.5 ±0.7)cm(t =7.65,P ＜0.01).The venous patency score before and after the thrombolysis were(15 ± 4)and(4 ± 3)(t =7.12,P ＜ 0.01).The mean rate of venous patency was 88.21％.In the 3 patients with pulmonary embolism,thrombus was complete dissolved in 1 case and partial dissolved in 2 cases.No major complications occurred in all these patients.29 patients were followed up for 3-12 months.There were no thrombosis relapsed.Conclusions Catheter-directed thrombolysis via the popliteal vein with urokinase for acute lower limb deep venous thrombosis is safe and effective.
