置管溶栓治疗急性下肢深静脉血栓形成28例

Catheter-directed thrombolysis for the treatment of acute lower extremity deep vein thrombosis: a report of 28 cases

目的:探讨置管溶栓治疗急性下肢深静脉血栓形成(DVT)的临床疗效。方法:对28例急性下肢DVT患者均行下腔静脉滤器置入术,同时行溶栓导管置于血栓处行溶栓治疗,溶栓第3、5、7天再经溶栓导管造影评价溶栓效果及静脉通畅程度,根据通畅程度行单纯球囊扩张或球囊扩张+支架置入术,术后观察临床疗效及出院随访。结果:置管溶栓术对急性下肢DVT有效率100%。溶栓成功后10例行单纯球囊扩张术,18例行球囊扩张+支架置入术。出院后继续口服抗凝药物6个月,并应用弹力袜促进下肢静脉回流。随访6个月至5年,疗效满意。结论:置管溶栓术及溶栓后单纯球囊扩张+支架置入是治疗急性下肢DVT的有效方法,创伤小,疗效高,并发症少,对防治下肢DVT后综合征有重要意义。

Objective： To study of the clinical efficacy of catheter-directed thrombolysis in the treatment of acute lower extremity deep vein thrombosis（ DVT）. Methods： Twenty-eight patients with acute DVT were performed inferior vona cava filter and catheter-directed thrombolysis; the blood flow rate was assessed by imaging test on the 3rd,5th and 7th day after insertion of the catheter. According to the results of the follow-up tests,the therapy of sole balloon dilatation angioplasty or combined with endovascular stenting was applied. The clinical effect was followed up. Results： Catheter-directed thrombolysis was efficacious in all the cases. Sole Balloon dilatation angioplasty was applied to 10 cases and balloon dilatation angioplasty combined with endovascular stenting to 18 cases. All the cases were administered oral anticoagulant and used graduated compression stockings. The follow-up lasted for 6 months to 5 years; and the curative effect proved satisfactory. Conclusions： Catheter-directed thrombolysis and the therapy of sole balloon dilatation angioplasty or combined with endovascular stenting are efficacious procedures for treatment of acute DVT with the advantages of small lesion,high efficacy and few complications,which is of great significance for the prevention and treatment of the disese.