CAJ | 학술논문

目的探讨妇科盆腔术后并发下肢深静脉血栓形成(DVT)早期应用溶栓的疗效及安全性.方法 25例妇科盆腔术后并发早期下肢DVT患者随机分为抗凝治疗组(抗凝组13例)和溶栓治疗组[重组组织纤溶酶原激活剂(rt-PA)组12例].抗凝组予低分子肝素0.4 ml/d皮下注射,rt-PA组在此基础上一次性予rt-PA 100 mg经患肢静脉注射,7 d观察静脉再通率、凝血酶原时间(PT)及出血等不良并发症.结果超声检查静脉rt-PA组复通率为91.7%(11/12),抗凝组为53.8%(7/13),2组差异有统计学意义(x2=15.68,P<0.01);2组各有1例发生阴道残端出血,未发现其他器官部位出血,2组出血率差异无明显统计学意义(x2=1.48,P>0.05),2例阴道残端出血患者均经局部止血后未再出血.结论 rt-PA用于妇科盆腔术后并发早期下肢.DVT的治疗,能有效提高下肢DVT静脉复通率,且不良反应较低.
목적 탐토부과분강술후병발하지심정맥혈전형성(DVT)조기응용용전적료효급안전성.방법 25례부과분강술후병발조기하지DVT환자수궤분위항응치료조(항응조13례)화용전치료조[중조조직섬용매원격활제(rt-PA)조12례].항응조여저분자간소0.4 ml/d피하주사,rt-PA조재차기출상일차성여rt-PA 100 mg경환지정맥주사,7 d관찰정맥재통솔、응혈매원시간(PT)급출혈등불량병발증.결과 초성검사정맥rt-PA조복통솔위91.7%(11/12),항응조위53.8%(7/13),2조차이유통계학의의(x2=15.68,P<0.01);2조각유1례발생음도잔단출혈,미발현기타기관부위출혈,2조출혈솔차이무명현통계학의의(x2=1.48,P>0.05),2례음도잔단출혈환자균경국부지혈후미재출혈.결론 rt-PA용우부과분강술후병발조기하지.DVT적치료,능유효제고하지DVT정맥복통솔,차불량반응교저.
Objective To explore the clinical effect and safety of using recombinant tissue type plasminogen activator (rt-PA) in early lower extremity deep venous thrombosis (DVT) after gynecological surgeries. Methods Twenty-five cases with early DVT after gynecological operation were enrolled and randomly divided into two groups,contorl group (n = 13) and the rt-PA therapy group (n = 12). The patients from contorl group were treated with Low-Molecular-Weight Heparins Calcium 0. 4 ml/d alone, and the rt-PA group accepted rt-PA 100 mg i. v in addition to the Low-Molecular-Weight Heparins Calcium. The recanalization rates of lamb veins,prothrombin time (PT) ,bleeding event and other adverse complications were observed and evaluated at day seven. Results The recanalization rates of lamb veins were 91. 7% (11/12) and 53. 8 % (7/13) in rtPA and the control group respectively,which showed significant difference between each other (x2 = 15. 68, P <0. 01). One case had vaginal stump bleeding in each group but no other hemorrhage in both group,the difference of bleeding rates between two groups didn't reach statistically significance (x2 = 1. 48 ,P> 0. 05). Two patients with vaginal stump bleeding were healed by local hemostasis. Conclusion The usage of rt-PA could improve the recanalization rate of DVT after gynecological surgery. The rates of adverse complications, including vaginal stump bleeding,were extremly low.