导管吸栓术与Fogart导管取栓术治疗重症下肢深静脉血栓形成对比研究

Treatment of phlegmasia cerulea dolens by DSA -guided sucking therapy vs. fogart catheter embolectomy

目的通过对导管吸栓术与Fogavt导管取栓术治疗重症下肢深静脉血栓形成的临床对比研究，探讨2种术式在安全性与临床疗效方面的差异。方法重症下肢深静脉血栓形成患者随机分成A、B两组，A组16例采用导管吸栓术，B组16例采用Fogart导管取栓术。2组均置入下腔静脉滤器并辅以置管溶栓，根据术后溶栓情况酌情取出滤器，所有病例术后维持抗凝及压力治疗6—12个月。结果A组术后3h患肢周径变化、术后镇痛治疗时间、术后腹股沟区淋巴漏发生率、术后滤器置留时间等指标均明显优于B组（P〈0．05）；术后随访6个月血栓形成后遗症发生率A组与B组差异无统计学意义（P〉0．05）。结论导管吸栓术较Fogart导管取栓术治疗重症下肢深静脉血栓形成具有更微创、更高效的临床特点，具有很高的临床应用价值。

Objective To compare the treatment of phlegmasia cerulea dolens by DSA - guided sucking therapy and Fogart catheter embolectomy and to explore the surgical safety and clinical efficacy differences between the two treatment methods. Methods The patients were randomly divided into groups A and B （n = 16 each）. Group A were treated with DSA - guided sucking therapy, group B were treated with Fogart catheter embolectomy. All patients were treated with inferior vend cava filter placement firstly, the inferior vend cava filter was retrieved after the patients were treated with thrombolysis. All patients were treated with antieoagulation and pressure therapy for 6 to 12 months after operation. Results Three hours after treated, the circumference changes of the limbs were greater, time of postoperative analgesic treatment was shorter, incidence rate of inguinal lymph leakage was lower in group A than in group B （P 〈 0.5 ）. Follow - up of 6 months showed equal incidence rate of asymptomatic pulmonary embolism （P 〉 0.05）. Conclusions DSA - guided sucking therapy is more minimally invasive and efficient, it has the greater clinical value than Fogart catheter embolectomy for the treatment of phlegmasia cerulea dolens.