经颈静脉置管联合足背静脉溶栓治疗混合型下肢深静脉血栓形成

Clinical investigation of trans-jugular catheterization thrombolysis combined with trans-dorsalis pedis vein access in the treatment of compound deep venous thrombosis of the lower limbs

目的探讨经颈静脉置管联合足背静脉溶栓治疗混合型下肢深静脉血栓形成的临床疗效。方法回顾性分析78例混合型下肢深静脉血栓形成患者临床资料。放置下腔静脉滤器后,经颈静脉置管溶栓治疗,同时予以经患侧足背静脉溶栓治疗。观察术后患者的临床症状和体征变化,行彩超评价静脉通畅程度,患者出院后经门诊随访其近期疗效。结果78例患者成功经右颈内静脉置管以及经患侧足背静脉溶栓。48例患者放置下腔静脉滤器,滤器放置成功率100%。术后患者的临床症状均明显缓解,彩超示下肢深静脉血流通畅。患者出院后随访1年,随访结果提示近期疗效满意。结论采用经颈静脉置管联合足背静脉溶栓治疗混合型下肢深静脉血栓形成可以取得较好的临床疗效。

Objective To investigate the clinical efficacy of compound deep venous thrombosis（DVT） treated with trans-jugular catheterization thrombolysis combined with trans-dorsalis pedis vein access.Methods Clinical data of 78 cases with compound DVT of the lower limbs were reviewed.The patients were treated with caterer-based thrombolysis via the jugular vein and trans-dorsalis pedis vein thrombolysis,among whom 48 patients underwent inferior vena cava filter implantation.The changes in the postoperative signs and symptoms were observed and the vein patency was assessed by the color Doppler ultrasound.The patients were followed up via their outpatient visits for the recent clinical efficacy as of their discharge from hospital.Results 78 cases with compound DVT of the lower limbs were successfully treated with caterer-based thrombolysis via the right jugular vein and trans-dorsalis pedis vein thrombolysis.48 cases were implanted with inferior vena cava filter before thrombolysis with a success rate of 100%.The clinical symptoms in all the patients were alleviated.Color Doppler ultrasound confirmed patent flow in the deep veins of the lower limbs.One-year follow-ups to the patients demonstrated satisfactory short-term therapeutic efficacy.Conclusion Catheter-based thrombolysis via the jugular vein and trans-dorsalis pedis vein access is an effective therapeutic strategy for the compound DVT of the lower limbs.