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下肢深静脉血栓形成215例临床分析

Clinical Analyses of 215 Cases Lower Limb Deep Venous Thrombogeneses
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摘要 目的:对近十年收治的下肢深静脉血栓形成均经深静脉顺行造影确诊共215例进行临床分析。方法:组1,病程3天内者,采用溶栓及手术取栓46例,后者仅2例。溶栓药尿激酶直接灌注患肢,50万单位/日,平均疗程7天;同时静脉滴注低分子右旋糖苷500ml/日。组2,病程3天以上,用抗凝为主的综合治疗169例。每日肝素钠盐水静滴12500单位,疗程21,同时同组1以低分子右旋糖苷静滴,患肢尿激酶灌流,疗程7天。结果:组1,治疗24~48小时除2例晚期癌症并盆腔转移疗程超过8个月仍有明显胀外,其余44例肿胀逐渐消退,平均住院10天,出院时患肢深静脉造影均恢复通畅,疗效满意,随访无复发。组2,除2例并发肺栓塞死亡外,167均有不同程度消肿,平均住院28天。出院时患肢深静脉造影,均显示下肢深静脉为完全闭塞或以闭 塞为主的部分再通。出院后静脉造影栓查151例中,完全闭塞为主的呈现部分再通28例,原为闭塞为主部分再通者,有16例已完全再通。但组2所有病人均伴有下肢浮肿、色素沉着、皮炎、溃疡等并发症。 Purpose: 215 cases of single lower limb deep venous thrombogeneses (DVT), which had been diagnosed by clinical examination and venography. Method: Group 1, 46 cases with diseased course were within 3 days, treated by thrombolytic drugs and surgical removal of thrombi (2 cases only). Hemolytic agent urokinase infused directly into the diseased deep vein, in a dosage of 500000U/day for 7 days, and also with intravenous drip of dextran 40 500ml/ day. Group 2, 169 cases the diseased course were longer, more than 3 days, treated by anticoagulants and comprehensive managements. The sodium heparin 12500U/day were infused intravenously for 21 days. As well as Group 1 dex- tran 40 and urokinase used in the same way. Result; Group 1, 2 cancer patients with pelvic metastasis hospitalized for more than 8 months, the limb edema did not improve significantly. The other 44 cases edema of limb eliminated gradually. Their hospitalization only 10 days in average. The deep venography revealed blood flowing freely with satisfactory effects. Afterward visits no recurrence were observed. Group 2, 2 cases died of pulmonary infarcts. 167 cases showed different degree improvement of lower limb edema. They discharged from the hospital about 28 days. During discharge the venography remained complete occultion or mainly occulted with partial flowing through. 151 cases had been afterward visited. The former, with complete occultion 28 cases turned to partial passing through, 16 cases of the latter condition turned to completely free flowing.
作者 李冠华
出处 《四川生理科学杂志》 2000年第3期28-31,共4页 Sichuan Journal of Physiological Sciences
关键词 患肢 再通 造影 下肢深静脉血栓形成 疗程 出院时 低分子右旋糖苷 平均 单位 目的 deep venous thrombogenesis thrombolytic drug anticoagulants
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