抗凝疗法与抗凝结合克栓酶疗法对急性下肢深静脉血栓的疗效比较

Clinical Comparisons of the Acute Lower Extremity Deep Venous Thrombosis Treatment between Anticoagulation Therapy and Anticoagulation Combined with Thrombolitic Therapy

目的总结下肢深静脉血栓的临床治疗经验.方法回顾性分析76例急性下肢深静脉血栓患者:单纯抗凝疗法者31例,抗凝结合克栓酶疗法45例,对比两组患者治疗前后主观症状、体征、后期并发症、血管超声和血液生化指标等,经统计学检验来判断是否抗凝结合克栓酶疗法具有比单纯抗凝更加优异的疗效.结果两组患者均顺利出院.就出院时患肢肿胀平均减轻程度、纤维蛋白原降低程度和血流通畅程度恢复而言,抗凝+溶栓组明显优于单纯抗凝组,差异有统计学意义(P均<0.05).两者3个月以内发生肺梗的机率大致相同.结论抗凝结合溶栓能显著提高急性下肢深静脉血栓的疗效.

Objective To review clinical experiences in the treatment of DVT, and to improve cure rate and reduce incidence of sequelae. Methods A retrospective analysis was performed from 76 clinically confirmed cases （i.e. 31 cases treated with mere anticoagulation therapy, group A versus 45 cases with both anticoagulation and thrombolytic therapy, group B）. Symptom, physical examinations, Doppler results, coagulation profiles and post-thrombotic sequelae were compared between the two groups. Results All patients in both groups recovered well after treatment. Whereas in the case of hospitalization, extent of edema relief, fibrinogen （Fib） reduction, hemodynamic improvement and post-thrombotic syndrome, group B was prior to group A （P 〈 0.05 ）. rates of pulmonary embolism within 3 months were almost the same. Conclusion On the base of therapy, using thrombolytic drugs will improve the therapeutic effects on DVT. However, coagulation