顺行取栓、交叉转流治疗急性下肢深静脉血栓17例

Experience on treating lower extremity DVT by ascending venous thrombectomy combined with across shunt above pubis in 17 cases

探讨急性下肢深静脉血栓的手术治疗方法。方法 :彻底地顺行取出下肢深静脉内的血栓。在取栓过程中若遇到左髂静脉病变者 ,采用取自体大隐静脉作左股静脉耻骨上交叉转流并建立临时性动静脉瘘 ,术中、术后辅以溶栓抗凝治疗 ,术后 2个月结扎临时性动静脉瘘。结果 :17例患者有 14例症状消失 ,有效率为 82 .35 % ,全组患者无死亡。结论 :顺行取栓、取自体大隐静脉耻骨上交叉转流及临时性动静脉瘘手术治疗急性下肢深静脉血栓 ,具有手术创伤小、操作简便、安全等优点。

Objective:To explore a new surgical method to deal with lower extremity deep vein thrombosis(DVT).Methods:At first,the lower extremity DVT must be cleared away entirely by ascending vein thrombectomy.During the process of thrombectomy,an across shunt above pubis was done by using autogenous great saphena with a temporary arteriovenous fistula built when meeting the lesion in left iliac vein.In addition,thrombolytic and anticoagulant therapy must also be given in and post operation.The temporary arteriovenous(A V) fistula would be closed two months after operation.Results:Symptoms of preoperation were disappeared in 14 of 17 cases there is 82.35% in efficient rate without death.Conclusions:This method that deal with acute lower extremity DVT by ascending venous thrombectomy combined with across shunt above pubis and temporary A V fistula has a lot of advantages,such as,minor injury,little expense and safety and easy performing. [