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张青云,高建国,陈泳,张弘,张琳娜,耿艳侠,高畅,李平,杨植,张小明.下腔静脉滤器植入及导管溶栓在下肢深静脉血栓形成治疗中的应用[J].陆军军医大学学报(原第三军医大学学报),2010,32(17):1887-1890.
Zhang Qingyun,Gao Jianguo,Chen Yong,Zhang Hong,Zhang Linna,Geng Yanxia,Gao Chang,Li Ping,Yang Zhi,Zhang Xiaoming.Application of inferior vena cava filter placement and catheter-guided thrombolysis in treatment of deep venous thrombosis in lower extremities[J].J Amry Med Univ (J Third Mil Med Univ),2010,32(17):1887-1890.
张青云,高建国,陈泳,张弘,张琳娜,耿艳侠,高畅,李平,杨植,张小明.下腔静脉滤器植入及导管溶栓在下肢深静脉血栓形成治疗中的应用[J].陆军军医大学学报(原第三军医大学学报),2010,32(17):1887-1890. DOI:
Zhang Qingyun,Gao Jianguo,Chen Yong,Zhang Hong,Zhang Linna,Geng Yanxia,Gao Chang,Li Ping,Yang Zhi,Zhang Xiaoming.Application of inferior vena cava filter placement and catheter-guided thrombolysis in treatment of deep venous thrombosis in lower extremities[J].J Amry Med Univ (J Third Mil Med Univ),2010,32(17):1887-1890. DOI:
目的 探讨下腔静脉滤器植入及导管溶栓治疗下肢深静脉血栓形成的临床疗效。 方法 收集42例我科2008年6月至2010年1月住院的急性下肢深静脉血栓形成患者,其中男性20例,女性22例,年龄22~79(48±15)岁。依就诊先后顺序随机分为3组(n=14):A组,下腔静脉滤器保护下全身溶栓、抗凝治疗;B组,下腔静脉滤器保护下,经溶栓导管溶栓、抗凝治疗;C组,抗凝治疗。以肢体周径差、血栓溶解程度,介入治疗并发症及肺栓塞发生情况为指标评价近期疗效,半年后随访。 结果 各组健、患肢周径差值均减小,B组患肢肿胀消退较A、C组快(P<0.01)。B组血栓完全消失5例(35.71%),与A、C两组比较,溶栓疗效显著(P<0.01)。B组尿激酶用量(1.56±5.80)×10
6
U,较A组[(3.06±8.24)×10
6
U
]
明显减少(P<0.01)。A组出现肉眼血尿、滤器移位各1例,C组出现肺栓塞1例。34例患者取得随访,随访6~18个月。无滤器移位及血栓形成。B组中仅1例出现下肢深静脉功能不全症状。 结论 下腔静脉滤器植入结合导管溶栓治疗下肢深静脉血栓形成疗效显著,安全性高。
Objective To study the efficacy of inferior vena cava filter (IVCF) placement and catheter-guided thrombolysis on deep venous thrombosis (DVT) in lower extremities. Methods Forty-two patients with acute DVT in lower extremities (20 males and 22 females) at the age of 22-79 years ( mean 48±15 years) admitted to our department from June 2008 to January 2010,were randomly divided into groups A,B and C in the order of their admission time
14 patients in each group. Patients in group A received system
ic thrombolysis and anticoagulation therapy after IVCF placement. Patients in group B underwent anticoagulation therapy and catheter-guided thrombolysis after IVCF placement. Patients in group C received only anticoagulation therapy. Results The difference was reduced in circumference of healthy and affected lower extremities after treatment. The resolution time of swelling in affected extremity was shorter in group B than in groups A and C (P<0.01). The thrombi were completely disappeared in 5 patients (38.71%) of group B. The resolution time of thrombi was shorter in group B than in groups A and C (P<0.01). The mean dose of urokinase used in group B was(1.56±5.80)×10
6
units
which was significantly lower than that used in group A(P<0.01). Gross hematuria was observed in 1 patient and displacement of IVCF occurred in 1 patient of group A
respectively. Pulmonary embolism (PE) occurred in 1 patient of group C. Thirty-four patients were followed up for 6-18 months
during which no PE and displacement of IVCF were found,except for deep vein dysfunction in lower extremities of 1 patient in group B. Conclusion IVCF placement and catheter-guided thrombolysis are a safe and effective procedure for acute DVT in lower extremities.
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