急性下肢深静脉血栓的腔内机械性血栓碎吸及溶栓介入治疗

Interventional Therapy by Mechanical Intubation and Aspiration of Debris and Thrombolysis Treatment for Acute Lower Extremity Deep Venous Thrombosis

目的探讨急性下肢深静脉血栓(lowerextr emity deep venous thrombosis,LEDVT)腔内机械性血栓碎吸及溶栓介入治疗的疗效。资料与方法对136例急性LEDVT患者于DSA下顺行股、髂静脉造影后,在下腔静脉滤器保护下,首先行机械性大腔导管血栓碎吸治疗,然后留置导管腔内溶栓治疗。对136例中并发13例急性肺栓塞(pulmonary emblism,PE)患者也采取腔内机械性血栓碎吸和溶栓介入治疗。结果136例介入治疗有效率100%,患者平均住院时间为7.5天。患肢肿胀、疼痛均于介入治疗后1～2天内开始消退。出院时健、患肢膝关节上、下15cm处周径差及患肢膝关节上、下15cm处周径与入院时比较,差异均有统计学意义(P<0.01)。结论腔内机械性血栓碎吸及溶栓介入治疗严重急性LEDVT疗效显著,病程短,是安全、有效的方法。

Objective To discuss the effect of interventional therapy by mechanical intubation and aspiration of debris and thrombolysis treatment for acute lower extremity deep venous thrombosis （LEDVT）. Materials and Methods Antegrade femoris, vena iliaea phlebography and interventional therapy was performed in acute LEDVT（ 136 patients）. After treating with inferior vena cava filter, firistly all patients were treated with mechanical intubation and aspiration of debris and thrombolysis through indwelling catheter later. 13 patients with PE were all resuced by aspiration of debris treatment and thrombolysis treatment. Results Total achievement ratio by interventional therapy was 100% , the average days in hospital was 7.5 days. Swelling and pain in affected limb disappeared or relieved after interventional therapy for 1 - 2 days. Knee joint upper and down 15 cm perimeter of uninjured and injured side had statistical difference, Knee joint upper and down 15cm perimeter of before and after threapy had statistical difference. Conclusion Mechanical intubation and aspiration of debris and thrombolysis treatment for acute lower extremity deep venous thrombosis is a safe and effective method.