下腔静脉滤器植入后导管接触性溶栓治疗下肢深静脉血栓形成的临床研究

Study on catheter-directed thrombolysis for deep venous thrombosis of the lower limbs after the implantation of inferior vena cava filter

目的探讨下腔静脉滤器置入后,经皮下肢深静脉置管局部溶栓治疗下肢深静脉血栓形成的可行性及疗效。方法42例下肢深静脉血栓形成患者,分为两组,介入治疗组15例,对照组27例。介入治疗组的15例患者行下腔静脉滤器植入术,经溶栓导管泵入大剂量尿激酶溶栓;对照组30例患者经足背静脉泵入尿激酶。结果介入治疗组血栓完全消失8例(53.33%),部分消失7例(46.67%),无明显好转0例(0%),治疗全过程所有患者均未出现肺动脉栓塞症状及出血现象;对照组血栓完全消失2例(7%),部分消失25例(83.33%),无明显好转3例(10%)。结论下腔静脉滤器置入后,患肢深静脉置管大剂量尿激酶溶栓治疗下肢深静脉血栓形成安全、疗效显著。

Objective To investigate the feasibility and efficacy of catheter-directed thrombolysis for deep venous thrombosis （DVT） of lower limbs after the implantation of inferior vena caval （IVC） filter. Methods 42 Patients with DVT were divided into 2 groups： interventional therapy group and control group. In interventional therapy group, 15 patients underwent inferior vena caval（IVC）filter implantion and catheter-directed interventions for thrombolysis. In the control group, antegrade infusion of urokinase was performed via the dorsalis pedis vein of the involved lower limb in 27 cases. Results In the interventional therapy group, complete disappearance of thrombus, partial disappearance of thrombus and ineffective treatment were in 8 （53.33%）and 7 （46.67%） and 0 （0%）cases respectively. In the control group,complete disappearance of thrombus ,partial disappearance of thrombus and ineffective treatment were in 2（7%）and 25（83.33%） and 3（10%） cases respectively. No pulmonary embolism and hemorrhage were found in the course of thrombolysis. Conclusion Catheter-directed thrombolysis therapy is an effective and safe therapeutic method for the treatment of DVT of lower extremity.