导管直接溶栓治疗急性下肢深静脉血栓形成

Catheter-directed thrombolysis for acute deep venous thrombosis of lower limbs

目的 探讨导管直接溶栓在治疗急性下肢深静脉血栓形成中的疗效.方法 2009年9月至2013年9月,采用经小隐静脉为主多途径置管溶栓治疗急性下肢深静脉血栓形成36例,通过观察治疗前后患、健肢周径差的变化、静脉通畅评分及静脉通常率来分析治疗效果.结果 36例患者经导管直接溶栓后,除1例左下肢急性下肢深静脉血栓合并下腔静脉血栓效果不明显外,22例显效,13例有效,总有效率97.2％（35/36）.溶栓前静脉通畅评分为（11.85±1.12）分,溶栓后为（3.60±1.53）分,两者比较差异有统计学意义（P＜0.01）.溶栓后静脉通畅率为（69.6±14.8）％.结论 经小隐静脉为主多途径置管溶栓治疗下肢深静脉血栓形成安全有效,创伤小,恢复快,值得临床推广.

Objective To explore the efficacy of catheter-directed thrombolysis （CDT） for acute deep venous thrombosis （DVT） of lower limbs.Methods The clinical data of 36 patients with acute DVT of lower limbs treated by CDT form September 2009 to September 2013 were analyzed respectively.Efficacy were assessed through observation of the circumferences,venous patency score and venous patency rate before and after thrombolysis.Results After treated by CDT,the effect of only 1 case with left lower limb DVT associated with inferior vena cava thrombosis was not obvious.The effects of 22 cases were excellence,and 13 cases were good.The total efficiency was 97.2%（35/36）.The venous patency scores before and after CDT were （11.85 ± 1.12）,（3.6 ± 1.53） points,and there had significant difference （P 〈 0.01）.After CDT,the venous patency rate was （69.6 ± 14.8）%.Conclusion Multi-channel CDT with small saphenous vein for acute DVT of lower limbs is safe and effective,with less invasion and quicker recovery.It is worthy of promotion in clinic.