产后下肢深静脉血栓68例治疗分析

Treatment for postpartum deep vein thrombosis of the lower extremity:an analysis of 68 cases

目的：探讨单纯抗凝和抗凝联合置管溶栓两种不同方法治疗产后下肢深静脉血栓形成（deep vein thrombosis，DVT）的疗效。方法回顾性分析2010年1月至2013年12月期间我科收治的68例产后 DVT 患者的临床资料，单纯抗凝治疗30例，抗凝联合置管溶栓38例，通过下肢深静脉造影来评价早期疗效，通过治疗后6~24个月随访情况来评价中期疗效。结果置管溶栓（catheter directed thrombolysis，CDT）组总有效率达86.84%，单纯抗凝组总有效率为53.33%。6~24个月内血栓形成后综合征（post-thrombosic syndrome，PTS）发生率置管溶栓组为5.26%，单纯抗凝组为26.67%。结论 CDT 治疗产后 DVT 可显著提高早期下肢深静脉复通率，并可有效降低PTS 的发生率。

Objective To explore the curative effects of simple anticoagulation and combined catheter-directed thrombolysis（CDT）for postpartum deep vein thrombosis（DVT）of the lower extremity. Methods From January 2010 to December 2013,the clinical data of 68 patients with postpartum DVT were analyzed retrospectively,including 30 cases of simple anticoagulation and 38 cases of anticoagulation combined with CDT. Venography of the lower extremity was employed to evaluate the early effects and post-operative follow-up（6-24 months）was used to evaluate the mid-term efficacy. Results The total effective rate of CDT and simple anticoagulation was 86. 84% and 53. 33% . After 6-24 months follow-up,the inci-dence of post-thrombosic syndrome（PTS）in the CDT group and simple anticoagulation group was 5. 26%and 26. 67% . Conclusion For postpartum DVT,CDT can significantly increase the early stage recanali-zation rate of deep vein of the lower extremity and reduce the incidence of PTS effectively.