| 丁洋,万圣云,叶琨,等.置管溶栓治疗急性下肢深静脉血栓形成的不同入路分析[J].安徽医药,2017,21(7):1228-1230. |
| 置管溶栓治疗急性下肢深静脉血栓形成的不同入路分析 |
| Different methods of catheter-directed thrombolysis for deep venous thrombosis |
| 投稿时间：2017-02-02 |
| DOI： |
| 中文关键词: 静脉血栓形成 血栓溶解疗法 支架 血管成形术 |
| 英文关键词: Venous thrombosis Thrombolytic therapy Stent PTA |
| 基金项目: |
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| 中文摘要: |
| 目的 探讨置管溶栓治疗急性深静脉血栓形成的不同入路的优劣。方法 回顾性分析56例急性深静脉血栓形成的病人,采用不同入路行置管溶栓治疗,通过手术时间、治疗效果和并发症来评价各种入路治疗的效果。结果 病人分为4组:A组(10例,18%)经小隐静脉切开入路,平均手术时间为(30±4) min,1例(10%)切口延迟愈合,2例(20%)切口渗血；B组(29例,52%)经胫后静脉切开入路,平均手术时间为(32±5) min,2例(6.9%)切口延迟愈合,4例(13.8%)切口渗血；C组(15例,27%)经胫前静脉穿刺入路,平均手术时间为(20±3) min,2例(13.3%)误穿入胫前动脉。D组(2例,3%)经健侧股静脉入路,平均手术时间(31±4) min。4组病人治疗前后各组间大腿周径差均差异有统计学意义(χ2=54.5,P＜0.05)。4组病人治疗前和治疗后各组间大腿周径差均差异无统计学意义(χ2=5.4,P＞0.05)。结论 对于不同病人采取个体化治疗,建议首选胫前静脉穿刺入路,为病人提供最大收益和最低风险的理想治疗方式。 |
| 英文摘要: |
| Objective To explore the advantages and disadvantages of different methods of catheter-directed thrombolysis in the treatment of acute deep venous thrombosis.Methods Retrospective analysis was made of 56 cases of acute deep vein thrombosis;thrombolytic therapy was performed with different approaches.The effect of each treatment was evaluated in the operation time,the efficacy and complications.Results The patients were assigned into four groups.Group A (10 cases,18%) was treated with small saphenous vein incision;the average operation time was(30±4) min;there were 1 case (10%) of delayed healing,2 cases (20%) of incision bleeding.Group B (29 cases,52%) was treated by posterior tibial vein incision;the average operation time was(32±5) minutes;there were 2 cases (6.9%) of delayed healing,4 cases (13.8%) of incision bleeding.Group C (15 cases,27%) was treated by anterior tibial vein puncture;the average operation time was(20±3) minutes;there were 2 cases (13.3%) of posterior tibial vein incision by mistake.Group D (2 cases,3%) was treated with the lateral femoral vein approach;the average operation time was(31±4) minutes;there was statistically significant difference in the circumference of the lower limbs between preoperation and postoperation(χ2 = 54.5,P<0.05).There was no statistically significant difference in the circumference among the four groups of patients before and after treatment (χ2 = 5.4,P> 0.05).Conlusions Individual treatment will be adopted for individual patient.The preferred approach is anterior tibial vein puncture,which can provide patients with the greatest benefits and the minimum risk. |
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