深静脉血栓形成的介入治疗

The Endovascular Therapy in Deep Venous Thrombosis

目的探讨对深静脉血栓形成(DVT)的患者进行介入溶栓治疗的选择原则和并发症的预防。方法38例DVT患者放置下腔静脉滤器后进行血管腔内治疗,包括静脉腔内插管溶栓术38例、球囊扩张术14例和支架放置术2例。48h照腹平片观察滤器的位置,1周后行彩色多普勒检查了解下腔静脉和病变深静脉的通畅度,出院后定期复查滤器位置和患肢情况。结果髂静脉、锁骨下静脉和肱静脉DVT的完全缓解率为100%,股静脉DVT完全缓解率为93.3%,小腿静脉DVT为68.4%;其余为部分缓解。滤器放置成功率为100%,溶栓过程中及追踪复查均未发生肺动脉栓塞。结论深静脉血栓形成的患者进行介入溶栓治疗结合下腔静脉滤器放置术有效而安全,有较高的临床应用价值。

Objective To discuss the principals of endovascular thrombolytic therapy and the prevention of complications in the patients with deep venous thrombosis（DVT）. Methods After IVCF were implanted in 38 patients with DVT, 38 procedures of venous thrombolytic therapies, 14 venous balloon dilatations and 2 stenting were performed. The IVCF place was reviewed by plain film after 48 hour. The IVC and stenostic veins were assessed by Dopler Ultrasound after one week, and follow - up in period. Results The complete recover rate of thrombolysis in the patients with iliac, subclavian and axillian venous DVT were 100%, in that with femoral DVT was 93.33%, and in extremity DVT was 68.24% . The success rate of IVCF placement reached 100% . No pulmonary embolism occurred in all patients during the period of thrombolyfic therapy and following - up. Conclusions Due to it made the endovascular thrombolysis in the patients with DVT more safely, INCF placement is valuable for prevention of pulmonary embolism.