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机械性血栓清除术结合导管溶栓治疗骨折合并急性下肢深静脉血栓形成效果观察 被引量:15

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摘要 目的探讨机械性血栓清除术结合导管溶栓治疗骨折合并急性下肢深静脉血栓形成的效果及安全性。方法选择骨折合并急性下肢深静脉血栓形成患者24例,先行经皮穿刺下腔静脉可回收滤器置入术及骨科手术,再经腘静脉或股静脉途径行机械性血栓清除术及导管溶栓治疗(将50~100万IU尿激酶溶于500 mL生理盐水中,通过输液泵经溶栓导管持续泵入,溶栓时间为3 h),术后口服华法林或利伐沙班抗凝治疗至少3个月。术后随访,记录患者下肢肿胀、疼痛情况以及围手术期并发症发生情况,患者滤器置入体内时间、机械血栓清除术至滤器取出时间。手术前及手术后1周测量患肢和健肢大腿、小腿的周径差。结果 24例患者患肢肿胀、疼痛等症状明显缓解,围手术期无出血、肺栓塞等并发症发生,术后均成功取出腔静脉滤器。患者滤器置入体内时间为7~100天、平均30.8天,机械血栓清除术至滤器取出时间为6~86天、平均26.9天。患者手术前后大腿周径差分别为(5.9±1.5)、(1.7±2.0)cm,二者比较P<0.01;手术前后小腿周径差分别为(3.2±0.9)、(0.7±0.5)cm,二者比较P<0.01。随访3.2~22.5个月、平均13.5个月,下肢静脉彩超显示血流基本通畅。结论骨折合并急性下肢深静脉血栓形成患者骨科手术后给予机械性血栓清除术结合导管溶栓治疗安全、有效。
机构地区 北京积水潭医院
出处 《山东医药》 CAS 2018年第16期81-83,共3页 Shandong Medical Journal
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