经腘静脉穿刺导管抽吸介入治疗急性下肢深静脉血栓

Interventional Treatment by Popliteal Vein Puncture and Transcatheter Aspiration for Acute Lower Extremity Deep Venous Thrombosis

目的探讨经腘静脉穿刺导管抽吸治疗急性下肢深静脉血栓(lower extremity deep venous thrombosis,LEDVT)的临床应用价值。方法对32例LEDVT患者行经腘静脉穿刺导管抽取栓术为主的综合介入治疗,其中行导管血栓抽吸术32例,导管接触溶栓术32例,球囊扩张术18例,支架植入术12例。结果 32例介入治疗有效率100%,患者平均住院时间为8.4 d。患肢肿胀、疼痛均于介入治疗后1～2 d内开始消退。术后下肢静脉造影复查,静脉通畅率100%。出院时健、患肢膝关节上、下15 cm处周径差及患肢膝关节上、下15 cm处周径与入院时比较,差异有统计学意义(P<0.01)。治疗过程中无严重并发症发生。结论经腘静脉穿刺导管抽吸治疗LEDVT是一种快捷、有效的方法,值得临床推广使用。

Objective To discuss the clinical value of popliteal vein puncture and transcatheter aspi- ration in the interventional treatment for acute lower extremity deep venous thrombosis （LEDVT）. Methods Popliteal vein puncture and synthetic interventional treatment were performed in 32 cases, including catheter2 directed thrombolysis in 32 cases ,transcatheter aspiration in 32 cases, angioplasty 18 cases, and stenting in 12 cases. Results Total achievement ratio by interventional therapy was 100% ,the average days in hospital was 8.4 days. Swelling and pain in affected limb disappeared or relieved after interventional therapy for 1 -2 days. Vein patency rate was 100% when 32 patients received lower venography after treatment. Knee joint up- per and down 15 cm perimeter of uninjured and injured side had statistical difference. Knee joint upper and down 15cm perimeter o f before and after therapy had statistical difference. The cause of treatment does not appear serious complications. Conclusion Popliteal vein puncture and transcatheter aspiration for acute deep venous thrombosis of lower limb ＇is a quick and effective method, with better prognosis, which is worthy to be recommended.