急性下肢深静脉血栓形成外科治疗(附22例研究).doc

急性下肢深静脉血栓形成外科治疗(附22例研究)【摘要】目的探讨急性下肢深静脉血栓形成时腔静脉滤器保护下手术取栓的适应症及治疗效果。方法对手术取栓的22例急性下肢深静脉血栓形成患者的临床资料进行回顾性分析。结果经导管取栓术后,所有患者临床症状明显改善。术后静脉造影示:12例深静脉全程基本通畅,6例为深静脉短段闭塞;余呈全肢型静脉血栓。 全组患者滤器置入者16例,位置适中,无滤器释放不全、穿孔、移位、血肿、出血或释放通路血栓形成等,无术后死亡病例或肺动脉栓塞发生。 6例未滤器置入者,合并轻微肺动脉栓塞2例,无死亡病例。术后随访1-3年,除3例仍有下肢轻微肿胀外,其余病例无明显肿胀、浅静脉曲张、溃疡等,在循序减压护套的支持下能正常工作生活。结论在下腔静脉滤器保护下行股静脉切开Forgarty导管取栓术治疗急性下肢深静脉血栓形成具有安全、疗效好、恢复快等优点。但应严格掌握适应症,其术后远期通畅率也有待进一步提高。 【关键词】急性深静脉血栓形成 适应症 取栓术 静脉滤器 中图分类号:R543.6 文献标识码:A 文章编号:1005-0515(2010)07-015-03 Surgical Treatment of Acute Deep Venous Thrombosis of Lower Limbs ZHENG Xian-jie,ZHANG Shuang-lin*, ZHANG Zhuang,ZHAO Ai-guo,ZHANG Guo-yu,ZHANG Xiao-yang,DUAN Shu-min, 1.Department of Cardiovascular Surgery,the First Affiliated Hospital He Nan University KaiFeng,HeNan,475003 【Abstract】Objective To investigate the effect and indication of thrombectomy with the protection of caval vein filter on patients with acute deep venous thrombosis of low extremity. MethodsClinical data of 22 cases after thrombectomy were analyzed retrospectively. ResultsAll cases gained clinical effects after they were underwent surgical thrombectomy. Postoperative phlebography results: canalization was achieved in 12 cases; six cases were segmental complete obstruction; I was entire limb-type vein thrombosis. Sixteen cases were underwent vena cava filter placement appropriately without pero-releasing. There were no perforation, displacement, hematoma, hemorrhage, thrombogenesis in the releasing way. And there were no postoperative dead cases or pulmonary embolism. Among 6 cases without filter, two cases developed pulmonary embolism, but no death. From one to three years after operation: except three patients were still suffered with light lower limb swelling, no lower limb swelling, superficial varicosis and abscess appeared in all the other patients, and they could live and work normally supported by sheath. ConclusionsSurgical thrombectomy is safe and effective in treatment of acute deep venous