原发性髂股静脉血栓形成诊治探讨

An Investgation on the Treament of Primary Iliac Vein Thrombosis

三年来收治发病后三天内的急性原发性左髂股静脉血栓形成3例。第1例术后给肝素抗凝治疗,同时给低分子右旋醣酐、阿斯匹林、潘生丁等祛聚辅助治疗。出院后遗留下肢静脉功能不全。第2例术后除应用抗凝、祛聚等治疗外,还给尿激酶溶栓治疗,伤口两个多月才愈合,出院后下肢静脉功能良好。第3例单纯应用尿激酶溶栓,辅以祛聚药物,出院后下肢静脉功能良好。

In recent three years,three cases of the acute primary iliac vein throm-bosis formed within 72 hours were admitted to our surgical ward.For the first case,the heparin anticoagulant was used postoperatively and with the aid of antiagglutinating drugs such as dextrane,aspirine and persantine.The patient left an unperfect function of the leg vein.For the second case,besides the anticoagulant and the antiagglutinating treament,urokinase was used after the urgent thrombectomy to dissolve the thrombus.The function of the leg vein remains good.For the third case,we only used the urokinase to dissolve the thrombus associated with the antiagglutinating drugs.The function of the leg veins remains sufficient too.we agree to the proposal that for the primary iliac vein thrombosis formed within 48 hours,the principal method of treament is thrombectomy accmpanied with anticoagulant and antiagglutinati ng therapy;or if the thrombosis was formed within 72 hours,the fibrinolytic therapy with urokinase to dissolve the thrombus should be used.But if the thrombosis have formed for more than a week,the only method could be used is anticoagulant treament and functioning insufficiency of the leg veins nearly always remains ssubsequently.However,early diagnosis and the most favourable treament in time were emphasized.