球囊扩张术后局部溶栓治疗下肢深静脉血栓

Regional Thrombolysis for Lower Extremity Deep Venous Thrombosis after Ballooning

目的 评价球囊扩张后经导管直接溶栓对治疗下肢DVT的价值。方法 13例下肢静脉栓塞患者经静脉入路引入球囊导管 ,自血栓近心端逆行向血管远心端扩张 ,再行导管局部溶栓治疗。术后每 2 4h静脉造影观察溶栓效果。结果 8例经静脉路径成功完成球囊扩张术及局部溶栓治疗 ,5例 2 4h完全溶栓 ,3例 72～ 96h ,溶栓剂用量平均 10 6 .2 5万u。结论 球囊扩张术后局部溶栓治疗能快速恢复血液循环 ,增强溶栓效果 ,迅速缓解患者症状。

Objective To evaluate the efficacy of catheter directed thrombolysis after ballooning in treating lower extremity deep venous thrombosis(DVT). Methods The popliteal vein was preferred venous access. Once the guide wire was across the thrombotic occlusion, a balloon catheter was advanced into inferior vena cava and ballooning was proformed retrogradelly. After that, the regional thrombolysis was made. The venography was done every 24 hours to observe the effect of thrombolysis. Results 8 of 13 patients was successfully across the thrombosed veins with guide wire and thrombolysis was conducted regionally after ballooning. The complete lysis was achieved for 5 patients in 24 hours and 3 within 72～96 hours. The average dose was 1.06 million IU. Conclusion Regional thrombolysis for treatment of lower extremity DVT is safe and effective, which is useful to restore the blood flow for the thrombosed vein and to enhance the effect of thrombolysis. [