妊娠及产褥期妇女并发下肢深静脉血栓溶栓治疗的临床疗效观察

Effect of thrombolytic therapy for gestational and puerperium patients with deep venous thrombosis

目的探讨妊娠及产褥期妇女并发下肢深静脉血栓溶栓治疗的临床疗效。方法选择2012年3月至2015年7月在河南省郑州市第十五人民医院妇产科住院治疗的69例妊娠及产褥期并发下肢深静脉血栓患者作为研究对象,均给予尿激酶静脉溶栓治疗以及肝素抗凝治疗,比较其治疗前及治疗后3、7 d的各项凝血功能指标、患肢肿胀程度和各项下肢阻抗容积波图指标变化情况。结果治疗前及治疗后3、7 d患者的Fi B呈显著下降趋势,而PT、APTT均呈显著升高趋势(均P<0.001);治疗后3、7 d患者的股骨中段周径、胫骨中段周径均显著减小(均P<0.001);与健侧相比,患者患肢肿胀程度明显改善(P<0.05);治疗前及治疗后3、7 d患者的IPG升高值、IPG下降值、IPG下降值/IPG升高值、阻抗变化比率均呈显著升高趋势(均P<0.001)。结论溶栓治疗快速溶解下肢血栓、改善其静脉回流,对于妊娠及产褥期并发下肢深静脉血栓患者具有较为明显的临床疗效。

Objective To explore the effect of thrombolytic therapy for gestational and puerperium patients with deep venous thrombosis. Methods 69 gestational and puerperium patients with deep venous thrombosis from March 2012 to July 2015 were selected as research group. All patients received thrombolytic therapy. The coagulative function index, swelling degree of affected limb, lower limbs wave impedance volume figure index of all patients before treatment, 3-days and 7-days after treatment were analysed. Results The FiB showed a decreasing trend and the PT and APTT showed a increasing trend （all P〈0.001）.The perimeter of middle femoral and middle tibia showed a decreasing trend after treatment （all P〈0.001）.The rising value of IPG, decreasing value of IPG, Rise/decline in value of IPG, and impedance change ratio were all increased （all P 〈 0.001）. Conclusions Thrombolytic therapy can dissolve intravascular thrombus quickly and improve venous flow. It has obvious curative effect for gestational and puerperium patients with deep venous thrombosis.