CAJ | 학술논문

目的：探讨抗磷脂综合征（APS）合并下肢深静脉血栓（DVT）的综合介入治疗疗效。方法回顾性分析2010年1月-2013年10月的10例APS合并DVT病例的临床资料。单纯抗凝组（A组）4例，经颈内静脉置管溶栓并联合全身抗凝组（B组）6例，术后均口服华法林至少1年。结果2组患者治疗前一般资料具有可比性。 A组治疗前两大腿周径差为（5.55±0.51）cm，治疗后为（1.85±0.31）cm，B组治疗前两大腿周径差为（5.13±0.45）cm，治疗后为（0.95±0.26）cm ，两组患者治疗前、后患肢腿周径均有缩小（均P<0.01），B组较A组明显（P<0.05）。 B组消肿率比A组消肿率高[（81.7±4.1）%比（67.3±3.6）%，P<0.01]。 B组平均住院时间少于A组[（13.83±0.75）d比（20.75±2.63）d，P<0.05]。 A组3例有效，1例无效；B组患者均治愈。结论经颈静脉置管溶栓联合全身抗凝治疗APS合并DVT疗效明显，并且安全、省时；单纯抗凝治疗疗效有限。
목적：탐토항린지종합정（APS）합병하지심정맥혈전（DVT）적종합개입치료료효。방법회고성분석2010년1월-2013년10월적10례APS합병DVT병례적림상자료。단순항응조（A조）4례，경경내정맥치관용전병연합전신항응조（B조）6례，술후균구복화법림지소1년。결과2조환자치료전일반자료구유가비성。 A조치료전량대퇴주경차위（5.55±0.51）cm，치료후위（1.85±0.31）cm，B조치료전량대퇴주경차위（5.13±0.45）cm，치료후위（0.95±0.26）cm ，량조환자치료전、후환지퇴주경균유축소（균P<0.01），B조교A조명현（P<0.05）。 B조소종솔비A조소종솔고[（81.7±4.1）%비（67.3±3.6）%，P<0.01]。 B조평균주원시간소우A조[（13.83±0.75）d비（20.75±2.63）d，P<0.05]。 A조3례유효，1례무효；B조환자균치유。결론경경정맥치관용전연합전신항응치료APS합병DVT료효명현，병차안전、성시；단순항응치료료효유한。
Objective To evaluate the therapeutic results of comprehensive interventional therapy for antiphospholipid syndrome (APS) complicated by deep vein thrombosis (DVT). Methods A total of 10 patients with APS complicated by DVT, who were encountered at authors’ hospital during the period from January 2001 to October 2013, were enrolled in this study. The patients included 3 males and 7 females with a mean age of 45 years (39-74 years). The patients were divided into pure anticoagulantion therapy (group A, n = 4) and catheter-based thrombolysis via the jugular vein combined with anticoagulantion therapy (group B, n = 6). The clinical data were retrospectively analyzed. After the treatment warfarin was orally administered in all patients for at least one year. Results There were no significant differences in general clinical characteristics between the two groups. Before the treatment, the circumference difference of the thighs was (5.55 ± 0.51) cm in group A and was (5.13 ± 0.45) cm in group B. After the treatment, the circumference difference of the thighs was (1.85 ± 0.31) cm in group A and was (0.95 ± 0.26) cm in group B. In both groups, the postoperative calf size was significantly reduced when compared with the preoperative one (both P < 0.01), which was more obvious in group B than in group A (P < 0.05). The detumescence rate in group B was significantly higher than that in group A, which was (81.7 ± 4.1)% vs (67.3 ± 3.6)%(P <0.01). The average hospitalization days of group B and group A were (13.83 ± 0.75) days and (20.75 ± 2.63) days respectively, and the difference was statistically significant (P < 0.05). In group A, clinical effective result was obtained in three patients and ineffective result in one patient, while in group B clinical cure was obtained in all patients. Conclusion In treating APS complicated by DVT, catheter-based thrombolysis via the jugular vein combined with anticoagulantion therapy is safe, effective and time-saving, while pure anticoagulation therapy has only limited efficacy.