逆行置管溶栓治疗急性髂股静脉血栓形成的对照研究

A case control study of the retrograde catheter directed thrombolysis in treating acute iliofemoral venous thrombosis

目的探讨经健侧股静脉穿刺逆行置溶栓导管治疗急性髂股静脉血栓形成的效果。方法对27例B型超声明确诊断为急性髂股静脉血栓患者,分为经对侧股静脉穿刺逆行置管溶栓组(A组)12例和全身静脉溶栓组(B组)15例。对2组患者患肢周径缩小值、远期瓣膜功能进行观察比较。结果治疗14d下肢周径缩小值,A组为(3.4±0.8)cm,B组为(2.8±0.8)cm,差异无统计学意义(P>0.05);治疗6个月后,经光电容积描记法(PPG)评价深静脉瓣膜功能,A组静脉充盈时间(VRT)为(22.2±3.5)s,B组为(16.6±4.1)s,差异有统计学意义(P<0.05)。结论经健侧股静脉穿刺置溶栓导管治疗急性髂股静脉血栓形成可有效改善深静脉瓣膜功能,降低静脉血栓后遗症发生率。

Objective To investigate the efficacy of retrograde catheter directed thrombolysis through femoral vein of unaffected limb in treating acute iliofemoral venous thrombosis.Methods 27 patients with acute iliofemoral deep venous thrombosis diagnosed by mode B ultrasound were divided into Group A（patients treated with catheter directed thrombolysis, n=12）and Group B（patients treated with systemic thrombolytic,n=15）.The reduction of the affected limb perimeter and long term function of valve of both groups were observed and compared.Results After 14 days treatment,the differences of the reduction of lower limb perimeter between Group A and Group B（3.4 cm±0.8 cm for Group A and 2.8 cm±0.8 cm for Group B）are of no statistical significance（P 0.05）.After 6 months treatment,the deep venous valve function was evaluated by photoplethysmography（PPG）with the results that the venous refill time（VRT）were 22.2 s±3.5 s for Group A and 16.6 s±4.Is for Group B,and the differences between them are statistically significant（P 0.05）.Conclusion Retrograde catheter directed thrombolytic through femoral vein of unaffected limb in treating acute iliofemoral venous thrombosis can effectively improve the deep venous valve function and reduce the incidence of complications of venous thrombosis.