| 苏威强,沈冬冬,付艳忠.溶栓药物联合大腔导管抽吸治疗下肢深静脉血栓 34例[J].安徽医药,2023,27(5):954-958. |
| 溶栓药物联合大腔导管抽吸治疗下肢深静脉血栓 34例 |
| Clinical study of thrombolytic drugs combined with large lumen catheter aspiration in the treatment of lower extremity deep vein thrombosis in 34 cases |
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| DOI：10.3969/j.issn.1009-6469.2023.05.023 |
| 中文关键词: 静脉血栓形成 下肢 溶栓药物 腘静脉置鞘 预处理 大腔导管抽吸术 |
| 英文关键词: Venous thrombosis Lower extremity Thrombolytic drugs Popliteal vein sheathing Pretreatment Large lumen |
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| 中文摘要: |
| 目的探究溶栓药物联合大腔导管抽吸治疗下肢深静脉血栓的临床效果。方法前瞻性选取焦作市第二人民医院 2018年 6月至 2020年 12月下肢深静脉血栓病人 68例，按照随机数字表法分组，各 34例。对照组给予大腔导管抽吸治疗，观察组给予溶栓药物经腘静脉置鞘预处理联合大腔导管抽吸。比较两组治疗效果、手术前后患侧 -健侧大小腿周径差、凝血纤溶指［血清 D-二聚体(D-D)、纤维蛋白降解产物( FDP)、纤维蛋白原( FIB)］、血液流变学［血红蛋白( Hb)、红细胞平均体积( MCV)、红标细胞压积( HCT)、血小板压积( PCT)］，并对比两组术后血栓后综合征发生率。结果观察组总有效率( 94.12%比 76.47%)、术中即时血栓清除率高于对照组，血栓抽吸时间［(292.26±61.48)s比( 340.53±72.39)s］短于对照组( P<0.05)；两组术后 1d、术后 3d患侧 -健侧大腿周径差、患侧 -健侧小腿周径差小于入院时，观察组小于对照组( P<0.05)；术后 1d、术后 3d两组血清 D-D、 FDP、FIB低于入院时，观察组低于对照组( P<0.05)；两组术后 1d、术后 3 d Hb低于入院时，观察组高于对照组， MCV、PCT、HCT低于入院时，观察组低于对照组( P<0.05)；两组术后 3个月、 6个月血栓后综合征发生率差异无统计学意义( P>0.05)；观察组术后 12个月血栓后综合征发生率低于对照组( 12.50%比 34.38%，P<0.05)。结论溶栓药物经腘静脉置鞘预处理联合大腔导管抽吸治疗下肢深静脉血栓疗效显著，能明显缩短血栓抽吸时间，减轻患肢肿胀，改善凝血功能、血液流变学，降低术后血栓后综合征发生率。 |
| 英文摘要: |
| Objective To explore the clinical effect of thrombolytic drugs combined with large lumen catheter aspiration in the treat-ment of deep vein thrombosis of lower extremities.Methods A total of 68 patients with deep venous thrombosis of lower extremities inJiaozuo Second People's Hospital from June 2018 to December 2020 were prospectively selected and grouped according to the randomnumber table method, with 34 cases in each group. The control group was given large lumen catheter aspiration, while the study groupwas given thrombolytic drugs through the popliteal vein sheath preconditioning combined with large lumen catheter aspiration. Thetreatment effect, the difference in the circumference of the affected side and the contralateral leg before and after surgery, the coagula-tion and fibrinolysis indexes [serum D-dimer (DD), fibrin degradation product (FDP), fibrinogen (FIB)], Hemorheology [hemoglobin(Hb), mean corpuscular volume (MCV), hematocrit (HCT), platelet volume (PCT)], and the incidence of post-thrombotic syndrome be-tween the two groups were compared. Results The total effective rate (94.12% vs. 76.47%) and immediate intraoperative thrombusclearance rate in the study group were higher than those in the control group, and the thrombus aspiration time in the study group wasshorter than that in the control group [(292.26±61.48)s vs. (340.53±72.39)s] (P<0.05). The difference of calf circumference between theaffected side and the unaffected side, and the circumferential diameter between the affected side and the unaffected side of the calf inthe two groups after 1 day and 3 days after surgery were smaller than that at admission, and those in the study group were smaller thanthose of the control group (P<0.05). D-D, FDP and FIB in the two groups were lower than those at the time of admission 1 day and 3days after the operation, those in the study group were lower than those in the control group (P<0.05); Hb in the two groups was lowerthan that at the time of admission 1 day and 3 days after the operation, the study group was higher than the control group; MCV, PCTand HCT were lower than those at the time of admission, and those in the study group were lower than those in the control group (P< 0.05); there was no significant difference in the incidence of post-thrombotic syndrome between the two groups at 3 months and 6 months after operation (P>0.05); the incidence of post-thrombotic syndrome at 12 months after operation in the study group was lower than that in the control group (12.50% vs. 34.38%, P<0.05).Conclusions Thrombolytic drugs through the popliteal vein sheath pre-conditioning combined with large lumen catheter aspiration for the treatment of lower extremity deep vein thrombosis has a significant effect, which can significantly shorten the thrombus aspiration time, reduce the swelling of the affected limb, improve coagulation func-tion, hemorheology, and reduce incidence of postoperative postoperative thrombotic syndrome. |
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