抗凝、溶栓、取栓治疗下肢深静脉血栓疗效比较

Comparsion of Efficacy of Anticoagulants Thrombolysis and Eembolectomy in Deep Vein Thrombosis of Femoral Fracture Surgery

目的:探讨股骨骨折术后下肢深静脉血栓(DVT)的有效治疗方法。方法:将63例股骨骨折手术后DVT病例分为3组,抗凝组口服低分子肝素(LMWH)和华法林,溶栓组在放置下腔静脉滤器(IVCF)基础上联合尿激酶治疗,取栓组在放置IVCF同时行导管取栓治疗。结果:总体疗效取栓组优于溶栓组,溶栓组优于抗凝组;使用IVCF组与未使用IVCF组肺栓塞发生率有显著差异(P<0.01)。结论:股骨骨折术后DVT发生后,以取栓的近期疗效为著,使用IVCF可使肺栓塞发生率降低。

Objective To investigate the efficacy of therapeutic methods in preventing deep vein thrombo- sis （DVT） formation after femoral fracture surgery. Methods Sixty three cases of femoral fracture surgeries were divided into three groups randomly. Anticoagulants therapy used low molecular weight heparin and warfarin; thrombolysis therapy used inferior vena cava filters （IVCF） and urokinase; embolectomy therapy used IVCF and fogarty catheter embolectomy. Results The efficacy of emboleetomy was much better than that of throm- bolysis which had better effect than that of anticoagulants group. The incidence of pulmonary embolism （PE） dur- ing the treating course between IVCF treatment group and non-IVCF treatment group was significantly lower （P 〈 0.01）. Conclusion Anticoagulants, thrombolysis and embolectomy all show obvious therapeutic effects on the DVT formation but among them, the efficacy of embolectomy is better. The employment of IVCF can re- duce the incidence of PE significantly.