CAJ | 학술논문

目的探讨猪尾巴导管碎栓联合灌注溶栓在治疗Cockett综合征合并急性左下肢中央型深静脉血栓中的临床应用价值. 方法回顾性分析福建医科大学附属协和医院在2007年1月至2012年10月采用介入方法治疗急性下肢深静脉中央型血栓形成137例患者的临床资料.所有患者均行下腔静脉可回收滤器置入,其中采用单纯灌注溶栓术(溶栓组)81例,猪尾巴导管碎栓联合灌注溶栓(碎栓组)56例,2组临床资料差异无统计学意义(P＞0.05),具有可比性.术后均局部应用尿激酶溶栓、低分子肝素钙抗凝治疗.后期应用华法林抗凝6～12个月. 结果 2组共133例患者完成溶栓及碎栓疗程,治疗后症状均明显改善,碎栓组较溶栓组溶栓时间更短(P＜0.01),尿激酶用量更少(P＜0.01),碎栓组在治疗后的1、3、5d静脉通畅度评分显著优于溶栓组(P＜0.01),治疗后碎栓组静脉通畅度评分优于溶栓组(P＜0.01),总体静脉通畅率亦明显优于溶栓组(P＜0.01).121例患者(溶栓组70例,碎栓组51例)得到随访,随访率88.32％,失访16例(溶栓组11例,碎栓组5例).随访时间随访时间10～60个月,2组均未发生肺动脉栓塞.结论猪尾巴导管碎栓联合灌注溶栓治疗下肢深静脉血栓可提高溶栓效率,缩短溶栓时间,减少尿激酶用量.
목적 탐토저미파도관쇄전연합관주용전재치료Cockett종합정합병급성좌하지중앙형심정맥혈전중적림상응용개치. 방법 회고성분석복건의과대학부속협화의원재2007년1월지2012년10월채용개입방법치료급성하지심정맥중앙형혈전형성137례환자적림상자료.소유환자균행하강정맥가회수려기치입,기중채용단순관주용전술(용전조)81례,저미파도관쇄전연합관주용전(쇄전조)56례,2조림상자료차이무통계학의의(P＞0.05),구유가비성.술후균국부응용뇨격매용전、저분자간소개항응치료.후기응용화법림항응6～12개월. 결과 2조공133례환자완성용전급쇄전료정,치료후증상균명현개선,쇄전조교용전조용전시간경단(P＜0.01),뇨격매용량경소(P＜0.01),쇄전조재치료후적1、3、5d정맥통창도평분현저우우용전조(P＜0.01),치료후쇄전조정맥통창도평분우우용전조(P＜0.01),총체정맥통창솔역명현우우용전조(P＜0.01).121례환자(용전조70례,쇄전조51례)득도수방,수방솔88.32％,실방16례(용전조11례,쇄전조5례).수방시간수방시간10～60개월,2조균미발생폐동맥전새.결론 저미파도관쇄전연합관주용전치료하지심정맥혈전가제고용전효솔,축단용전시간,감소뇨격매용량.
Objective To evaluate pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated by Cockett syndrome in the left lower limbs.Method Data of 137 cases of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb by interventional therapy from January 2007 to October 2012 were analyzed retrospectively.Inferior vena cava filters were placed in all of the patients.Patients were divided into two groups:Group A (n =81) treated with catheter directed thrombolysis only,Group B (n =56) treated with pigtail catheter mashing thrombosis combined with catheter directed thrombolysis.After operation,patients were treated by anticoagulation with urokinase and heparin calcium,and then warfarin for 6 to 1 2 months.Results The thrombolysis time in group B was significantly shorter than that in group A (P ＜0.01),the dosage of urokinase was significantly less than that in group A(P ＜ 0.01).The venous patency score in group B after therapy was significantly better than in group A (P ＜ 0.01).121 patients were followed up for 10-60 months.There were no pulmonary embolism.Conclusions Pigtail catheter mashing thrombosis combined with catheter directed thrombolysis in the treatment of acute iliofemoral venous thrombosis complicated with Cockett syndrome in left lower limb can improve thrombolytic efficiency,shorten thrombolysis time,reduce the use of urokinase.