导管接触溶栓治疗急性下肢深静脉血栓形成临床疗效分析

Therapeutic effect of catheter-directed thrombolysis for acute lower limb deep venous thrombosis

关键词:  急性下肢深静脉血栓形成  下肢深静脉血栓形成后综合征  导管接触溶栓  抗凝

Key words:  acute lower limb deep venous thrombosis  catheter-directed thrombolysis  anticoagulation

摘要:

目的　评估导管接触溶栓（CDT）治疗急性下肢深静脉血栓形成（DVT）的临床疗效及长期并发症下肢深静脉血栓形成后综合征（PTS）的发生情况。方法　回顾性分析80例DVT患者的临床资料，其中CDT+规律抗凝（治疗组）40例，同期单纯规律抗凝（对照组）40例，比较治疗前后两组患者大、小腿，健、患侧肢体周径差。随访24个月，比较两组患者Villalta评分、PTS发生率、髂-骨静脉通畅率。结果　两组患者治疗后大、小腿，健、患侧肢体周径差明显小于治疗前，治疗组肢体肿胀症状缓解更明显。随访结果显示，Villalta评分：对照组(5.22±0.71)分高于治疗组(3.26±0.88)分，差异有统计学意义 (P<0.05)；对照组PTS发生率为45.00％ (18/40)， 高于治疗组27.50％ (11/40)，差异有统计学意义 (P<0.05)。髂-股静脉通畅率治疗组97.43%，高于对照组92.10%，差异有统计学意义(P<0.05)。结论　CDT联合规律抗凝治疗DVT，疗效确切、可以减少PTS的发生。

Abstract:

Objective　 To evaluate the clinical efficacy of catheter-directed thrombolysis (CDT) in the treatment of deep venous thrombosis (DVT) and investigate the incidence of post-thrombotic syndrome（PTS）. 　Methods　 The clinical data of 80 patients with lower limb DVT treated in the Department of Vascular Surgery in our hospital were retrospectively analyzed. The patients were divided into CDT group (40 cases) and Regular anticoagulation group (40 cases), in the same period. Circumference differences between suffered limb and healthy limb before and after treatment were compared and calculated. Patients were follow up for 24 months to evaluate Villalta score，incidence of PTS, and patency of Iliac vein. 　Results　 Preoperative and postoperative thigh /calf circumference differences were significantly decreased, especially in the treatment group. During follow-up, the Villalta score in control group was significantly higher than that in treatment group (5.22±0.71 vs. 3.26±0.88, P＜0.05). The incidence of PTS in control group (18/40, 45.00％) was higher than that in treatment group (11/40, 27.50％), the difference was statistically significant (P＜0.05). The patency of Iliac vein in treatment group was significantly higher than that in control group (97.43%vs. 92.10%, P＜0.05). 　Conclusions　 CDT combined with regular anticoagulant is safe and effective in the treatment of DVT, and has the effect of reducing the incidence of PTS.