期刊文献+

介入导管溶栓治疗急性下肢深静脉血栓形成32例 被引量:14

Catheter-directed thrombolysis for patients with acute deep venous thrombosis of the lower limb: report of 32 cases
原文传递
导出
摘要 目的 探讨经腘静脉置入溶栓导管持续灌注溶栓药物治疗急性下肢深静脉血栓形成(deep venous thrombosis,DVT)的临床应用价值.方法 本组32例急性DVT患者(其中3例合并肺动脉栓塞),男15例,女17例,年龄18 ~71岁,平均(51±17)岁.在超声引导下经患肢腘静脉穿刺置入溶栓导管至髂、股静脉血栓中进行溶栓治疗,并对溶栓效果进行分析.结果 全组患者溶栓后症状明显改善,下肢肿胀消退,肺部症状缓解.溶栓后患、健侧大腿周径差为(1.7±1.3)cm,明显小于溶栓前(5.4±1.4)cm,两者相比差异有统计学意义(t=9.92,P<0.01).患肢大腿消肿率为91.74%;溶栓后患、健侧小腿周径差为(1.5±0.7)cm,明显小于溶栓前(4.1±1.5)cm(t =7.65,P<0.01).患肢小腿消肿率为86.02%.溶栓前静脉通畅评分(15±4)分,明显高于溶栓后(4±3)分(t=7.12,P<0.01),溶栓后静脉平均通畅率为88.21%.3例合并肺动脉栓塞患者1例栓子完全溶解,2例大部分溶解.所有患者均无严重并发症.29例患者获随访,随访3 ~ 12个月,平均(7.8±2.4)个月.无一例出现血栓再发.结论 经腘静脉置管溶栓治疗急性DVT是一种安全、有效的治疗方法. Objective To evaluate catheter-directed thrombolysis via the popliteal vein in the treatment of the lower limb acute deep venous thrombosis.Methods From July 2009 to October 2010,32patients of the lower limb acute deep venous thrombosis including 3 patients with concurrent pulmonary embolism underwent uhrasound-guided catheter-directed thrombolysis via the popliteal vein.The thrombolytic catheter was inserted into thrombus,through which urokinase was infused at a dosage of 100 × 104U/d.The venous patency score and the rate of patency improvement were observed by venograms before and after therapy.Results In every patient,the lower limb swell and pulomonary symptoms relieved.The circumferences between affected and normal thigh before and after the thrombolysis were(5.4 ± 1.4)cm and (1.7 ± 1.3)cm(t =9.92,P 〈0.01).The circumferences between affected and normal leg before and after the thrombolysis were(4.1 ± 1.5)cm and(1.5 ±0.7)cm(t =7.65,P 〈0.01).The venous patency score before and after the thrombolysis were(15 ± 4)and(4 ± 3)(t =7.12,P 〈 0.01).The mean rate of venous patency was 88.21%.In the 3 patients with pulmonary embolism,thrombus was complete dissolved in 1 case and partial dissolved in 2 cases.No major complications occurred in all these patients.29 patients were followed up for 3-12 months.There were no thrombosis relapsed.Conclusions Catheter-directed thrombolysis via the popliteal vein with urokinase for acute lower limb deep venous thrombosis is safe and effective.
出处 《中华普通外科杂志》 CSCD 北大核心 2012年第1期28-30,共3页 Chinese Journal of General Surgery
关键词 静脉血栓形成 抗凝药 导管消融术 腘静脉 腔静脉滤器 Venous thrombosis Anticoagulants Catheter ablation Popliteal vein Vena cava filters
  • 相关文献

参考文献10

  • 1刘咸罗,钱小星,汤永胜,陈克辉,钱梅梅,柳小刚,周高潮,徐晓峰,王家文.急性下肢深静脉血栓形成的实验与临床研究[J].中国现代普通外科进展,2009,12(4):317-320. 被引量:21
  • 2Porter JM,Moneta GL.Reporting standards in venous disease:an update.J Vasc Surg,1995,21:635-645.
  • 3Segal JB,Streiff MB,Hofmann LV,et al.Management of venous thromboembolism:a systematic review for a practice guideline.Ann Intern Med,2007,146:211-222.
  • 4张柏根.下肢深静脉血栓形成治疗和预后的几个问题[J].中华普通外科杂志,2006,21(2):81-83. 被引量:115
  • 5Baldwin ZK,Comerota AJ,Schwartz LB.Catheter-directed thrombolysis for deep venous thrombosis.Vasc Endovasc Surg,2004,38:1-9.
  • 6Mewissen MW,Seabrook GR,Meissner MH,et al.Catheterdirected thrombolysis for lower extremity deep venous thmmbosis:report of a national multicenter registry.Radiology,1999,211:39-49.
  • 7张精勇,金星,吴学君,张十一,种振岳.滤器保护下置管溶栓治疗下肢深静脉血栓形成临床总结[J].中国实用外科杂志,2006,26(10):774-776. 被引量:24
  • 8Greenfild L J,Proctor MC,Micb AA.Recurrent thromboembolism in patients with vena cava filters.J Vasc Surg,2001,33:510-514.
  • 9Harenberg J.Fixed-dose versus adjusted-dose low molecular weight heparin for the initial treatment of patients with deep venous thrombosis.Curt Opin Pulm Med,2002,8:383-388.
  • 10Alesh I,Kayali F,Stein PD.Catheter directed thrombolysis (intrathrombus injection)in treatment of deep venous thrombosis:a systematic review.Catheter Cardiovasc Interv,2007,70:143-148.

二级参考文献34

  • 1Nicolaides AN, Breddin HK, Fareed J, et al. Prevention of venous thromboembolism[J]. Int Angid ,2001,20:1-39.
  • 2Baldwin ZK, Comerota AJ, Schwartz LB, et al. Catheter-directed thrombolysis for deep venous thrombosis [J]. Vasc Endovasc Surg, 2004,38:1-9.
  • 3Saarinen J, Kallio T, Lehto M, et al. The occurrence of the post- thrombotic changes after a acute deep venous thrombosis. A perspective two-year follow-up study[J]. Cardiovasc Surg, 2000,22:483-486.
  • 4Hume M. Presidential address: a venous renaissance? [J] Vasc Surg, 1992,5:947-981.
  • 5Nevelsteen A. Prophylaxis of venous thrombolism [J]. Int Angiol , 1996,15 (Suppl):3-4.
  • 6Comerota AJ,Gravett MH. Iliofemoral thrombosis [J]. Vasc Surg, 2007,46:1065-1076.
  • 7Puskas A, Belogh Z, Hadadi L, et al. Spontaneous recanalization in deep venous thrombosis: a prospective duplex ultrasound study[J]. Int Angiol, 2007,26:53-63.
  • 8Comerota A J, Paolini D. Treatment of acute iliofemoral deep venous thrombosis: A strategy of thrombosis removal [J]. Eur J Vasc Endovasc Surg, 2007;33:351-360.
  • 9Myers DD, Hawley AE, Farris DM, et al. P-selectin and leukocyte microparticles are associated with venous thrombogenesis [J]. Vasc Surg, 2003,38:1075-1089.
  • 10Krieger E, van Der Loo B, Amenn-Vesti BR, et al. C-reactive protein and red cell aggregation correlate with late venous function after acute deep venous thrombosis[J]. Vasc Surg, 2004,40:644-649.

共引文献148

同被引文献108

引证文献14

二级引证文献60

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部