超声消融结合三管微创法治疗下肢深静脉血栓115例

目的探讨治疗下肢深静脉血栓(DVT)微创、有效的新方法。方法用腔内超声消融导管,配合取栓、球囊扩张及内支架导管置入治疗下肢深静脉血栓(DVT)115例。结果111例(96.5%)阻塞静脉全部打通进入下腔静脉,术中血管造影示静脉平均狭窄由100%减少到28%±8%(P<0.01);4例(3.5%)部分开通左髂总静脉未进入下腔静脉;18例(15.6%)出现并发症,其中血管壁穿孔4例,健侧深静脉血栓4例,节段性肺栓塞3例,切口淋巴漏7例,均经保守治疗治愈。结论多种介入导管相互配合可明显提高DVT的疗效。

Objective： To evaluate micro-trauma and effective methods to treat the deep venous thrombi （DVT） in lower extremities. Methods： 115 cases with DVT were treated by transluminal ultrasound ablation combined with Fogarty embolectomy catheter, percutaneous transluminal angioplasty or endovascular stent placement. Results： The obstructed vein received complete recanalization in 111 cases （96.5.%） with the venous stenosis rate reduced from 100% to 28±8% （t= 6. 728,P〈0. 01）, partial recanalization in 4 cases with the entrance of common iliac vein to inferior vena cava obstructed. Complications occurred in 18 cases, include venous wall perferation 4 cases, healthy side DVT 4 cases,segmental pulmonary embolism 3 cases, incisional lymphatic fistula 7 cases, which were all cured by conservative treatment. Conclusion： Ultrasound ablation combining interventional methods could improve the therapeutic effect of DVT remarkably.