急性下肢深静脉血栓形成的综合治疗

Colnpositive treatment of acute deep vein thrombosis oflower extremlty

自１９９１年９月至１９９３年１０月，作者采用手术取栓（髂股静脉取栓术和顺行静脉取栓术），并辅以溶栓及抗凝的方法治疗１４例急性下肢深静脉血栓形成患者。经平均１１．５个月的随访，治疗优良率为７８．６％，后遗症发生率为２１，４％。由于取栓后打通了深静脉回路，可使溶栓剂最有效地发挥作用，并减少了溶栓剂用量，避免了出血并发症。顺行静脉取栓术，不仅可取出整个下肢全长的深静脉血栓，而且不损伤静脉瓣膜，降低了深静脉血栓后遗症的发生率。此外，术中应同时解决髂静脉本身的病变，如外压、狭窄、闭锁、隔膜形成等，否则易导致血栓复发。

AbstractFourteen patients with acute deep vein thrombosisof lower extremity (DVT) were treated with compositemethods including thrombectomy(iliofemoral venousthrombectomy and ascending venous thrombectomy),thrombolytic and anticoagulant therapy. Follow-up for2～27 months (average 11. 5 months ) showed excel-lent and good results in 78.6%, and the morbidity ofpost-thrombotic syndrome only 21.4%。 The remark-able results were due to opening of occlusive vein ofthe lower extremities bv thrombectomy, which couldmake thrombolytics effective and reduce the dose ofthrombolytics to prevent bleeding complication。 As-cending venous thrombectomy could not only removethe venous thrombi of the lower extremities but alsoprotect the deep venous valves and reduce the morbidi-ty of postthrombotic svndrome。 Additionally, to reacha satisfied therapy,lesion in iliac vein,such asanatomical compression , stenosis, occlusion,di-aphragm and so on, shall be managed as well. Other-wise,DVT shall be recurrent.