摘要
目的 探讨下肢深静脉血栓局部溶栓治疗的疗效及影响因素。方法 对 6 0例下肢深静脉血栓形成患者 ,采用经导管血栓局部先团注量灌注尿激酶 2 5 0 0 0 0U ,然后以 12 5 0 0 0～ 15 0 0 0 0U/h持续灌注。结果 全组溶栓治疗时间 4～ 76h ,平均 38h ,尿激酶用量 75 0 0 0 0U～ 975 0 0 0 0U ,平均5 15 0 0 0 0U ,血管再通率 88.3%。病程 <4周的急性或亚急性血栓形成患者 4 6例 ,溶栓后阻塞段血管再通 4 4例 (95 .7% )。在 14例慢性血栓形成患者中 ,血管再通 9例 (6 4 .3% )。对残存狭窄 >30 %的 2 3例患者 ,14例行经皮球囊血管成形术 (PTA)治疗 ,9例行PTA及内支架治疗。溶栓术后继续肝素全身抗凝治疗可增强溶栓疗效。 6例溶栓前放置下腔静脉过滤器。本组无严重并发症及肺栓塞发生。结论 经导管血栓局部灌注尿激酶是治疗下肢深静脉血栓的安全有效方法 。
Objective To investigate the influencing factors and therapeutic efficacy of regional thrombolysis with urokinase for treatment of lower extremity deep venous thrombosis. Methods 60 patients with lower extremity deep venous thrombosis (acute or subacute clots, n =46; chronic clots, n =14) received catheter guided regional thrombolysis with urokinase, using continuous infusion method (125 000 U/h to 150 000 U/h) with an initial bolus (250 000 U) before the infusion. Results In 60 cases, the average urokinase dose was 5 150 000 U (range, 750 000 U to 9 750 000 U) infused over an average of 38 hour (range, 4 hour to 76 hour), vessels recanalization rate was 88.3%. Effective clot lysis was accomplished in 44 of 46 (95.7%) patients with acute or subacute clots less than 4 weeks in duration, as well as in 9 of 14 (64.3%) patients with chronic clots. After thrombolysis, 23 cases with residual stenosis (>30%) were treated with angioplasty ( n =14) or angioplasty and stent placement ( n =9). Systemic heparin therapy can raise effectiveness of thrombolytic therapy after thrombolysis. 6 patients had inferior vena cava filters placed before the start of thrombolytic therapy. There were no major complications or clinically detectable pulmonary embolism. Conclusions Regional thrombolysis with urokinase for treatment of lower extremity deep venous thrombosis is safe and effective,but the effect is related to many influencing facters.
出处
《介入放射学杂志》
CSCD
2001年第5期264-267,共4页
Journal of Interventional Radiology
关键词
下肢深静脉
血栓形成
血栓溶解
介入性
Lower extremity deep vein,thrombosis
Thrombolytic therapy
Radiology, interventional
