导管介入溶栓治疗下肢深静脉血栓形成不同给药方式的疗效分析

Study of different modes of catheter-directed thrombolysis with recombinant staphylokinase in lower extremity deep venous thrombosis

目的:对下肢深静脉血栓形成(LDVT)病人,通过不同方式给予重组链激酶(r-SK)行导管介入溶栓(CDK)。动态观察D-二聚体以监测溶栓疗程中的继发纤溶状况,分析溶栓药经不同给药方式对临床疗效的影响。方法:对2007年1月至2008年6月收治的40例LDVT病人,经腘静脉置管行CDT治疗,术前随机分组(持续泵入组和间断冲击组各20例)。采用B超及深静脉造影监测血栓溶解及血管再通情况,分析2组病例的临床资料,比较其疗效和并发症发生率。结果:间断冲击组溶栓效果明显优于持续泵入组;2组溶栓并发症发生率差异无统计学意义;间断冲击给药溶栓疗程中无致死性并发症发生。结论:LDVT病人行CDT时,间断冲击给药方式,可有效地提高溶栓疗效,不增加溶栓并发症;可作为无明显出血倾向的LDVT病人CDT治疗时溶栓药物的首选给药方式。

Objective Patients with lower extremity deep venous thrombosis （LDVT） were treated with different modes of catheter-directed thrombolysis using recombinant staphylokinase. Dynamic changes of the D-dimer were observed to the occurrence of secondary fibrinolysis and the effect of thrombolytic therapy. By comparing of the clinical effects of different modes of administration of the thrombolytic drug, the best mode of administration was reached. Methods From April 2007 to March 2008, 40 cases were submitted to catheter-directed thrombolysis. They were divided into 2 groups randomly before operation：20 cases were given continuously pumping thrombolytic drug and another 20 cases were submitted to interrupted infusion of the drug. Vascular recanalization were compared between the 2 groups by ultrasound and angiography. Results Thrombolytic effect in the interrupted in fusion mode was significantly better than that of the continued pumping mode, while the complications of thrombolytic therapy showed no obvious difference between the 2 groups. Conclusions The interrupted infusion mode in administering recombinant staphylokinase to patients with LDVT appears preferable and may be associated a higher frequency of thrombolysis.