下肢深静脉血栓形成综合介入治疗的并发症及其预防

CO-THERAPY OF INTERVENTION FOR DEEP VENOUS THROMBOSIS OF LOWER LIMBS:ITS COMPLICATIONS AND PREVENTION

目的分析下肢深静脉血栓形成(DVT)介入治疗的并发症及其预防措施。方法 300例DVT病人,共312条患肢,其中周围型DVT者63例,中央型DVT者158例,混合型DVT者79例,髂静脉压迫综合征69例。所有病人均行经颈静脉插管尿激酶溶栓术,同时行抗凝治疗,122例行下腔静脉滤器植入术(93例行滤器取出),64例行髂静脉经皮腔内血管成形术(PTA),21例PTA后植入支架。术后随访12个月。结果共出现并发症58例,死亡2例。其中出血37例,腔静脉滤器相关性并发症11例,肺栓塞4例,髂静脉压迫综合征介入治疗相关并发症6例。结论 DVT介入治疗的并发症以出血和肺栓塞最为严重,应采取各种措施加以预防。

Objective To analyze the complications and their prevention of interventionaI therapy for deep venous throm- bosis （DVT） of lower limbs. Methods This study consisted of 300 patients with DVT, a total of 312 affected limbs were in- cluded. In which, 63 were peripheral, 158 were central type, 79 were mixed type, and 69 were iliac vein compression syndrome. All the patients underwent transjugular venous cannula urokinase thrombolysis, and anticoagulant therapy. Of which, 122 received implantation of inferior vena cava filter （93 were unloaded）, 64 underwent iliac vein percutaneous transluminal angioplasty （PTA）, and 21 underwent post-PTA iliac stent implantation. They were followed for 12 months after surgery. Results Complications were recorded in 58 cases, and death in two, which included hemorrhage （37 cases）, complications related to inferior vena cava fil- ter （11）, pulmonary embolism （four）, and complications associated with the treatment of iliac vein compression syndrome （six）. Conclusion Hemorrhage and pulmonary embolism are the most severe complications in DVT. Various measures concerned should be adopted to prevent beforehand.