经腘静脉顺行插管溶栓治疗中央型下肢深静脉血栓

Thrombolysis with direct intubation via popliteal vein in the treatment of central lower extremity deep venous thrombosis

目的通过对中央型下肢深静脉血栓患者经腘静脉顺行插管行溶栓治疗,探讨其治疗方法和效果。方法 2014年5月~2015年11月我院血管外科24例急性中央型下肢深静脉血栓（DVT）患者于DSA下置入可回收型下腔静脉滤器后,通过彩超定位行患侧腘静脉穿刺,置入直端多侧孔灌注导管,经导管以尿激酶微泵注射行溶栓治疗。结果治疗后患、健侧大腿、小腿周长差（2.68±1.27）cm、（1.75±1.16）cm明显小于治疗前的（6.45±2.74）cm、（5.82±1.94）cm（P〈0.05）。溶栓前静脉通畅评分为（8.65±1.68）分,溶栓后为（2.37±1.14）分（P〈0.05）。结论经腘静脉顺行插管溶栓治疗中央型下肢深静脉血栓是一种简便、疗效可靠的治疗方法。

Objective To explore the treatment method and effect of thrombolysis with direct intubation via popliteal vein in the patients with central lower extremity deep venous thrombosis（DVT）. Methods 24 patients with central lower extremity DVT who were in the vascular surgery of our hospital from May 2014 to November 2015 were selected. After implanted with retrievable inferior vena cava filters under digital subtraction angiography（DSA）,all patients were intubated with straight multiple side holes catheters via popliteal vein puncture under color ultrasound localization, and received thrombolysis therapies of urokinase injection by micro pump through catheter. Results After treatment, the thigh and shank circumference differences of affected and healthy sides of patients were（2.68±1.27）cm and（1.75±1.16）cm respectively,which were obviously smaller than the（6.45±2.74）cm and（5.82±1.94）cm before treatment（P〈0.05）.The venous patency score was（8.65±1.68） before thrombolysis,and became（2.37±1.14） after thrombolysis（P〈0.05）. Conclusion Thrombolysis with direct intubation via popliteal vein is simple, effective and reliable in the treatment of central lower extremity deep venous thrombosis.