下肢深静脉血栓介入性溶栓治疗效分析.docVIP

下肢深静脉血栓介入性溶栓治疗疗效分析 　　[摘要] 目的 探讨经导管介入下肢深静脉血栓溶栓治疗的临床疗效。方法 经知情同意后按随机数字表法将我院收治的86例下肢深静脉血栓患者分为对照组与实验组，各43例。对照组采用低分子量肝素结合华法林进行单纯抗凝治疗。实验组在对照组治疗基础上置入腔静脉过滤器，并采用经?N静脉介入导管，给予尿激酶进行导管溶栓治疗。比较治疗前后两组患者下肢患侧周径差、静脉通畅评分及临床疗效。结果 与对照组相比，治疗后实验组静脉通畅评分优于对照组[（5.02±1.22）分 vs （8.07±1.12）分]，深静脉通畅程度显著改善（P中国论文网 /6/viewhtm 　　[关键词] 介入；深静脉血栓；溶栓；下肢 　　[中图分类号] R543.6 [文献标识码] A [文章编号] 1673-9701（2017）31-0025-04 　　[Abstract] Objective To investigate the clinical efficacy of transcatheter interventional thrombolytic therapy in the treatment of deep venous thrombosis of lower extremities. Methods After informed consent， 86 patients with deep venous thrombosis of lower extremities who were admitted to our hospital were divided into control group and experimental group according to the random number table method， with 43 cases in each group. The control group was treated with low molecular weight heparin combined with warfarin for simple anti-coagulation therapy. The experimental group was further given placement of vena cava filter on the basis of the control group. The popliteal vein interventional catheter was applied， and urokinase was used for catheter thrombolytic therapy. The difference of diameter at the affected side of lower extremities， venous patency score and clinical efficacy were compared between the two groups before and after treatment. Results Compared with the control group， the venous patency score in the experimental group was better than that in the control group after treatment [（5.02 ± 1.22） vs 8.07 ± 1.12）]. The degree of deep vein patency was significantly improved （P 　　国内外研究显示，目前治疗下肢深静脉血栓的方法以抗凝治疗、系统性溶栓、血管腔内治疗及外科取栓四种治疗方式为主。虽然通过外科手术取栓能够较为快速有效地消除血栓，但其取栓创伤大、术中容易引起血栓脱落诱发急性PE、损伤静脉[3]。系统性溶栓则降低药物局部浓度，用药量大，容易并发出血性事件，风险较大。目前国内外推荐疗法中，以抗凝治疗为首选方法[4-6]，结合介入性溶栓治疗，提高局部药物浓度，降低风险，提高疗效。本研究将采用腔静脉过滤器置入，结合药物溶解深静脉血栓，降低静脉压，保护深静脉瓣膜功能，取得了较好效果，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　选取我院2013年4月～2017年7月经门诊收治的下肢深静脉血栓形成患者86例，全部患者均经过下肢深静脉造影检查确诊。经知情同意后，按随机数字表法将患者均分为对照组与实验组。其中对照组43例，男21例，女22例，年龄27～84岁，平均（53