经腘静脉置管溶栓联合下腔静脉滤器置入治疗急性下肢深静脉血栓形成

Inferior vena filter placement combined with catheter directed thrombolysis for lower extremity deep venous thrombosis via trans popliteal-vein approach

目的评价经腘静脉置管溶栓联合下腔静脉滤器置入治疗下肢深静脉血栓形成的疗效。方法回顾性分析98例应用导管溶栓联合滤器置入和经外周静脉溶栓的方法治疗下肢深静脉血栓形成患者的临床资料,比较两组肢体肿胀消退及并发症情况。结果 52例导管溶栓患者肢体肿胀均消退,无出血并发症,其中44例放置下腔静脉滤器,未发生肺栓塞。8例因拒绝而未放置滤器的患者,2例发生肺栓塞;而46例行外周静脉溶栓患者,26例肢体肿胀完全消退,发生消化道出血1例,尿道出血3例,肺动脉栓塞10例。结论导管溶栓具有并发症少、安全有效等优点,早期及时的滤器置入是防止肺栓塞的关键和有效措施。

Objective To evaluate the treatment effect of catheter directed thrombolysis for lower extremity deep venous thrombosis via trans popliteal-vein approach combined with inferior vena filter placement. Methods To analyze the clini- cal data of 98 DVT patients who were treated with catheter directed thrombolysis combined with inferior vena filter place- ment and conventional thrombolysis trans peripheral vein approach,retrospectively. The lower extremity detumescence and complication of two groups were compared. Results All lower extremities swelling totally fadeaway in 52 catheter directed thrombolysis patients, with no bleeding complication and no pulmonary embolism occurred in 44 of 52 cases placed inferior vena Filter, 2 of 8 cases who refused to place inferior vena filter occurred pulmonary embolism. While 26 of 46 who re- ceived thrombolysis trans-peripheral vein approach lower extremities swelling totally fadeaway, 1 case occurred hemorrhage of digestive tract, 3 cases occurred urethremorrhage, 10 cases occurred pulmonary embolism. Conclusion Catheter directed thrombolysis is effective and low complication for patients, early and timely placement of inferior vena filter is an effective way to prevent pulmonary embolism