急性下肢深静脉血栓形成128例诊治分析

Acute deep venous thrombosis of lower extremities: Experience of diagnosis and treatment in 128 cases

目的:分析急性下肢深静脉血栓形成(deep venous thrombosis,DVT)患者临床特征、危险因素及治疗方法。方法:对5年来我院收治的128例急性下肢深静脉血栓形成的住院患者进行回顾性分析。结果:本组所有病例均行腔静脉滤器置入,其中Aegisy先健滤器79例,贝朗等永久滤器47例,2例临时性滤器;导管溶栓97例,股静脉切开取栓31例;髂静脉球囊扩张23例,球囊扩张+支架植入15例。住院天数为12～30 d,平均(13.8±2.3)d。出院时患肢肿胀消退68例,肿胀明显缓解47例,另外13例治疗不满意。随访92例,其中58例基本无患肢肿胀症状;31例活动后患肢有轻度肿胀,休息后缓解;3例肿胀无缓解。本组无肺栓塞、脑出血及死亡病例。结论:引起下肢深静脉血栓形成的主要危险因素有手术、创伤、恶性肿瘤及长期卧床等,彩超是诊断的首选检查,针对不同患者采用腔静脉滤器植入、置管溶栓、取栓、滤器取出等相应的治疗方案临床效果理想。

Objective：To analyze the clinical features , risk factors and treatment strategies for patients with acute lower extremity deep vein thrombosis（ DVT） .Methods： A retrospective analysis was performed in 128 inpatients with acute DVT of lower extremities undergone treatment in our hospital during the past 5 five years.Results： All cases were per-formed with placement of vena cava filter（Aegisy filter in 79,VenaTech LP filter in 47,temporary filter in 2）.Ninety-seven patients received fem-oral vein catheter thrombolysis,and 31 were managed by thrombectomy, 23 by iliac venous percutaneous transluminal angioplasty （ PTA ） and an-other 13 by PTA and stent placement.The length of hospital stay ranged from 12 to 30 days（mean 13.8 ±2.3）.Upon discharge,the swollen limbs became completely subsided in 68 cases,evident remission in 47, yet another 13 were unsatisfactory.Follow-up of 92 cases suggested that 58 had no significant swelling of the lower extremities ,31 had mild swell-ing of the affected limb after exercise and 3 had no remission of the swell-ing.No ulmonary embolism,or cerebral hemorrhage or death occurred. Conclusion：The major risk factors for DVT are involved in surgical strat-egies,trauma, tumor and long-term bedridden.Color Doppler ultrasound shall be the preferable diagnostic strategy,and vena cava filter placement as well as catheter-directed thrombolysis,thrombectomy and removal of the filter may lead to satisfactory outcomes .