不同自然病程下肢深静脉血栓溶栓治疗的疗效观察:附146例报告

Results of thrombolytic therapy for different stages of deep venous thrombosis of the lower extremities

目的探讨下肢深静脉血栓溶栓治疗的方法和效果。方法回顾分析下肢深静脉血栓146例的临床资料,其中男87例,女59例;平均年龄49.7岁。根据其自然病程将上述患者按症状出现时间(而不是栓龄)分为3组:急性组40人(0～7d),亚急性组70例(8～30d)和慢性组36例(30d以上者)。分别对各组溶栓治疗前后股静脉流速峰值、内径变化,腘静脉流速峰值、内径变化,以及大、小腿周径改变等进行比较。结果溶栓治疗后患者股、腘静脉流速峰增加,增加最多的是急性组,其次为亚急性组,最少的是慢性组;溶栓治疗后患者股、腘静脉内径和大、小腿周径减少,减少最多的是急性组,其次为亚急性组,最少的是慢性组(均P<0.01)。结论下肢深静脉血栓溶栓治疗实施越早效果越好。积极的溶栓可以改善静脉梗阻和降低瓣膜破坏程度及减轻血栓后遗症的程度。

Objective To study the method and effect of thrombolytic therapy for deep venous thrombosis （DVT）.Methods We performed a retrospective analysis of the clinical data of 146 DVT cases,which were grouped into acute （0-7 d, n=40）, sub-acute （8-30 d, n=70） and chronic （3 d, n=36） series according to their course of disease. Statistical analysis was used to analyze the data including femoral vein peek velocity/diameter changes, popliteal vein peek velocity/diameter changes and circumference changes in the thigh and calf before and after treatment. Results Femoral and popliteal vein peek velocity increased after thrombolytic therapy. On the other hand, femoral and popliteal vein diameter, along with circumference in the thigh and calf, decreased after thrombolytic therapy, with the highest decrease in acute group and lowest decrease in chronic group.Conclusions As regards thrombolytic therapy, the earlier it is performed, the better will be the effects achieved. Aggressive thrombolytic therapy can improve venous obstruction and valve damage, and attenuate postthrombotic syndrome.