CAJ | 학술논문

　　目的探讨可回收腔静脉滤器置入联合患侧置管溶栓治疗下肢深静脉血栓形成（DVT）的早期和中期疗效。方法回顾性分析2009年2月~2012年10月期间我科收治的143例急性下肢 DVT 患者置管溶栓治疗的临床资料。通过静脉造影计算血栓溶解率来评价早期疗效；通过6个月和2年随访多普勒超声检查深静脉通畅率及 Villalta 评分测定深静脉血栓形成后综合征（PTS）发生率来评价中期疗效。结果143例患者平均血栓溶解率为（84.3±26.1）%，成功溶解（血栓溶解率≥50%）129例（90.2%）。6个月和2年深静脉通畅率分别为76.3%和68.7%，2年后 PTS 发生率为16.5%。穿刺点血肿5例，无严重并发症发生。结论急性下肢 DVT 血管腔内置管溶栓疗效显著而且安全，并且可以提高深静脉通畅率和降低 PTS 发生的风险。
　　목적탐토가회수강정맥려기치입연합환측치관용전치료하지심정맥혈전형성（DVT）적조기화중기료효。방법회고성분석2009년2월~2012년10월기간아과수치적143례급성하지 DVT 환자치관용전치료적림상자료。통과정맥조영계산혈전용해솔래평개조기료효；통과6개월화2년수방다보륵초성검사심정맥통창솔급 Villalta 평분측정심정맥혈전형성후종합정（PTS）발생솔래평개중기료효。결과143례환자평균혈전용해솔위（84.3±26.1）%，성공용해（혈전용해솔≥50%）129례（90.2%）。6개월화2년심정맥통창솔분별위76.3%화68.7%，2년후 PTS 발생솔위16.5%。천자점혈종5례，무엄중병발증발생。결론급성하지 DVT 혈관강내치관용전료효현저이차안전，병차가이제고심정맥통창솔화강저 PTS 발생적풍험。
Objective To explore the early and medium-term efficacy of catheter-directed thrombolysis(CDT) combined with retrievable vena cava filter for acute deep vein thrombosis(DVT) in the lower extremity. Methods The clinical data of 143 patients with acute DVT of lower extremities treated by CDT from February 2009 to October 2012 were analyzed retrospectively. Early efficacy was assessed with a thrombus score based on venography. Six months and 2 years follow-up included deep vein patency assessed with duplex ultrasound, and post- thrombotic syndrome (PTS ) assessed with the Villalta scale. Results The mean thrombolysis rate was (84.3±26.1)%, and successful thrombolysis (thrombolysis rate ≥ 50%)was obtained in 129 patients(90.2%). Deep vein patency after 6 months and 2 years were 76.3% and 68.7%, respectively. The incidence of PTS was 16.5%. Hematoma occurred in 5 cases at the puncture site, and no major complications happened. Conclusion CDT is safe and effective for acute DVT. It can increase lower extremity deep vein patency and reduce the risk of PTS.