摘要
目的:比较血栓碎吸术与系统静脉溶栓治疗中央型下肢深静脉血栓形成(LEDVT)的疗效。方法:2009年10月—2012年8月收治的173例急性中央型LEDVT患者随机分为实验组(行血栓碎吸术,97例)和对照组(行单纯静脉溶栓,96例)。测量2组治疗前、后患肢腿围,比较2种治疗方法的临床疗效及其预后。结果:实验组出院时患肢膝上、下15cm处周径差与入院比较差异有统计学意义(P<0.05);出院时造影静脉通畅率100%。对照组出院时患肢膝上、下15 cm处周径差与入院比较亦差异有统计学意义(P<0.05);出院时静脉造影通畅率91.67%(88/96)。实验组入、出院患肢膝上、下15cm处周径差的差值较对照组更大(P<0.05),住院时间较对照组减少(P<0.05),出院时静脉造影通畅率较对照组高(P<0.05)。由于实验组中18例合并髂静脉狭窄或闭塞患者行支架植入,实验组住院费用较对照组高(P<0.05)。结论:对于急性LEDVT患者,与系统静脉溶栓治疗相比,血栓碎吸术治疗疗效显著,能够缩短住院时间,提高静脉通畅率,远期疗效有待进一步研究。
Objective： To discuss the clinical effect of mechanical aspiration thrombectomy and intravenous thrombolysis for lower extremity deep venous thrombosis of central type. Meth. ods： 193 patients with lower extremity deep venous thrombosis of central type in our hospital be- tween October 2009 and August 2012 were enrolled in this study. They were divided into two groups randomly, including test group in which 97 patients were treated by mechanical aspiration thrombectomy, and control group in which 96 patients were treated by intravenous thrombolysis. The test group was consisted of 55 men and 42 women, ranging in age from 36 years old to 84 years old, the control group was consisted of 53 men and 43 women, ranging in age from 37 years old to 82 years old. There was no statistical difference between two groups in age, sex and onset time （P〉0.05）. Patients in test group were placed by the temoprary inferior vena cave filters in femoral vein of healthy side, and then we inserted a 14 F catheter to the femoral vein of affected limbs. The venous thrombosis was crumbled by ballon inserted according the catheter and aspirated mechani- cally. 18 patients complicated with lilac vein stenosis or occlusion were treated by PTA and stent im- plantation. Heparin therapy was used to anti-coagulation after operation. We measured the preop- erative and postoperative circumference of affected limb, record the effectual-time and compared the clinical effect in two groups. Results： tn test group, the circumference differences of knee-joint＇s above and below 15 cm of healthy and affected limbs at discharge were （1.52 ±0.61） and （0.89 ± 0.37）cm, which showed statistical difference to that of admission（P〈0.05）. The hospi- talization time were （ 7.23 ±0.37） days （6 - 9 d）. The hospitalization expenses were 8159.35 ± 1325.20 yuan （6 000 - 15 000）. The vein patency rates at discharge was 100%. The complication rate was 0%. In control group, the circumference differences of knee-joint＇s above and below 15 cm of healthy and affected limbs at discharge were （1.32 ±0.48） and （0.67 ±0.25）cm cm, which showed statistical difference to that of admission（P〈0.05）. The hospitalization time were 9.15 ± 0.75 days（8- 16 d）. The hospitalization expenses were（7 356.95 ±1 173.30） yuan（5 000 ± 18 000 yuan）. The vein patency rates at discharge was 91.67% （88/96）. There was statistical difference in the cir- cumference differences between two groups （P〈0.05）. The hospitalization time in test group was significantly less than that of control group（P〈0.05）. The vein patency rates in test group was signif- icantly less than that of control group （P〈0.05）. The hospitalization expenses in control group was significantly less than that of test group （P〈0.05）. Conclusions： for the patients of lower extremi- ty deep venous thrombosis of central type, mechanical aspiration thrombectomy, which might shorten hospitalization time and Improving venous patency rate, played more remarkable effect than intravenous thrombolysis. We need further research for its long-term effect.
出处
《中国现代普通外科进展》
CAS
2013年第9期695-699,共5页
Chinese Journal of Current Advances in General Surgery
关键词
深静脉血栓
机械性血栓碎吸
溶栓
Lower extremity deep venous thrombosis.Mechanical aspiration thrombectomy, Thrombolytic
