介入治疗下肢深静脉血栓的临床应用

Interventional Therapy for Deep Venous Thrombosis in the Lower Limbs

目的 探讨介入治疗下肢深静脉血栓(deep venous thrombosis,DVT)的效果. 方法 38例DVT均行深静脉置管接触性溶栓,12例联合血管球囊扩张及血管内支架置入术.按我院疗效观察标准:治愈,造影检查示血栓完全溶解,静脉壁光滑;显效,静脉回流通畅,静脉内有附壁血栓,管腔内径≥2/3;有效,静脉内仍有血栓残留,管腔内径＜2/3;无效,造影检查示静脉回流不通畅. 结果 治愈22例,显效14例,有效2例.治疗中无严重并发症发生.34例随访3～24个月,其中3～6个月7例,7～12个月12例,13～24个月15例,血栓复发2例,经再次深静脉置管接触性溶栓治疗后部分再通. 结论 介入治疗DVT操作简便,安全有效.

Objective To investigate the clinical effectiveness of interventional therapy for deep venous thrombosis(DVT) in the lower limbs.Methods A total of 38 patients with DVT were treated by intravenous thrombolysis;12 of them received percutaneous transluminal balloon angioplasty and intravascular stenting after the thrombolysis.According the evaluation criteria of our hospital,the outcomes of the patients were classified as cure(angiography showed complete lysis of the thrombus and smooth venous wall),markedly improved(the deep vein was patent with intravascular mural thrombi,the inner radius was reduced by less than 1/3),improved(angiography showed residual thrombi in the deep vein,and the inner radius was reduced by more than 1/3),and failure(the vein was still obstructed).Results After the treatments,cure was achieved in 22 patients,markedly improved in 14,and improved in 2.No severe complications occurred during the operations.Thirty-four of the patients were followed up for 3-24 months(3-6 months in 7 cases,7-12 months in 12,and 13-24 months in 15).Two patients had recurrence during the follow-up and were cured by intravenous thrombolysis.Conclusion Interventional therapy is continent,effective,and safe for DVT.