介入插管联合足背静脉溶栓治疗下肢深静脉血栓的体会

Interventional catheterization combined dorsal venous thrombolytic therapy for treatment of lower extremity deep venous thrombosis

目的探讨介入插管联合足背静脉溶栓治疗下肢深静脉血栓的疗效。方法我院从2006年1月～2011年11月对50例下肢深静脉血栓的患者行治疗,3例CTA证实有肺动脉栓塞,治疗方法为介入插管联合足背静脉尿激酶溶栓,左下肢44例,右下肢6例,其中4例为cockett综合征,3例左髂总静脉狭窄闭塞,行球囊扩张后弹性回缩,行codis血管内支架置入,1例右髂总静脉狭窄,行球囊扩张后血流通畅,所有病例均放置下腔静脉滤器,血栓溶解后取出滤器44枚,6例因患者年龄大,家人要求不取而未取出,1例因滤器上方贴血管壁,采用创新方法取出。结果所有病例均成功溶解血栓,下肢肿胀完全缓解,插管成功率为100%。尿激酶总量平均1000万U,溶栓导管保留10～20天,平均12天。结论介入插管联合足背静脉尿激酶溶栓治疗下肢深静脉血栓安全有效。

Objective To explore the curative effect of Interventional catheterization combined dorsal venous thrombolytic therapy for treatment of lower extremity deep venous thrombosis. Methods In our hospital from January 2006 to November 2011 50 cases of lower limb of deep vein thrombosis received treatment, in which 3 cases was diagnosed pulmonary embolism with CTA. Interventional catheterization combined dorsal venous thrombolytic therapy with urokinase was performed in left lower limb in 44 cases, right lower limbs in 6, 4 cases for cockett syndrome, 3 patients with left iliac total vein occlusion of the narrow, line after the balloon expansion vessels, line codis endovascular stents, 1 case right iliac total vein stenosis, and done after the balloon expansion blood unobstructed. All cases were placed the inferior vena cava filter, and filter was taken out after thrombolytic in 44 cases. Because of aged, the filter was leaved in vessels in 6 cases. And in 1 case the filter was stacked to blood vessel ~ wall, and taken with innovative method. Results All cases were successful in thrombolysis, lower limb swelling complete response, the success rate of 100%. The average total dose of urokinase was 10 million U, thrombolysis catheter retained for 10-20 days, in average, 12 days. Conclusion The Interventional catheterization combined dorsal venous thrombolytic therapy is safe and effective for treatment of lower extremity deep venous thrombosis.