手术联合腔内技术治疗下肢深静脉血栓形成

Thrombectomy combined with endovascular therapy in treatment of deep venous thrombosis of lower extremities

目的:总结手术联合腔内技术治疗下肢深静脉血栓形成(deep venous thrombosis,DVT)的初步经验。方法:对48例下肢DVT患者采取腔静脉滤器植入、股静脉切开取栓、髂静脉球囊扩张内置支架以及暂时性动静脉瘘等方法治疗。结果:随访1-38个月,26例肢体肿胀消退,无浅表静脉怒张,11例肢体轻微肿胀伴浅表静脉扩张,3例肢体肿胀稍消退,症状有所减轻,1例支架内血栓形成。无肺栓塞发生,无滤器内血栓残留。1例术后1个月对侧肢体发生DVT。结论:本法创伤小,操作简单,安全、有效,是治疗下肢DVT较好的选择,但远期疗效有待进一步研究。

Objective：To summarize the preliminary experience of thrombectomy combined with endovascular therapy in treatment of deep venous thrombosis （ DVT ） of lower extremities. Methods： The clinical data of 48 patients undergoing the vena cava filter implanting,thrombectomy, the iliac vein venoplasty, the stenting and temporary arteriovenous fistula were analyzed retrospectively. Results：After the follow-up ranging from 1 month to 38 months, the limbs swelling generally disappeared in 26 patients, 11 had mild limbs swelling accompanied with superficial venous varicose, the limbs swelling was a little bit better in 3 but the symptom were alleviated and 1 patient had stent thrombosis. No pulmonary embolism occurred and no thrombi residual was found in the vena cava filter. One patient had secondary deep venous thrombosis on the contralateral limb one month postoperatively. Conclusions： The procedure is minimally invasive, simple, safe and effective. The long-term efficacy is under further research.