经腘静脉置管溶栓治疗下肢深静脉血栓的疗效分析

Clinical analysis of popliteal venous catheter thrombolysis for deep venous thrombosis of lower extremity

目的评价经腘静脉置管溶栓对下肢深静脉血栓(deep venous thrombosis of lower extremity,LDVT)的临床疗效。方法回顾性分析2014年9月至2016年9月乐山市人民医院收治的82例急性LDVT患者的临床资料,分析全身溶栓组及置管溶栓组患者的肢体消肿率和血栓溶解率。结果全身溶栓组47例,溶栓前后大腿周径差分别为(7.72±1.67)cm和(3.05±1.03)cm,小腿周径差分别为(4.35±0.84)cm和(2.12±0.92)cm;置管溶栓组35例,溶栓前后大腿周径差分别为(7.86±2.23)cm和(1.81±0.68)cm,小腿周径差分别为(4.24±0.68)cm和(1.56±0.38)cm。置管溶栓组的肢体消肿率、血栓溶解率较全身溶栓组高,差异有统计学意义(P<0.05)。结论经腘静脉置管溶栓对急性LDVT的疗效明显,是一项安全有效的治疗方式,但其个体化治疗方案仍需要进一步研究。

Objective To evaluate the clinical curative effect of popliteal venous catheter thrombolysis for deep venous thrombosis of lower extremity （LDVT）. Methods Clinical data of 82 cases with LDVT admitted in Leshan People＇s Hospital from September 2014 to September 2016 were retrospectively analyzed. Limb detumescence rate and thrombolysis rate of patients in systemic thrombolytic group and catheter thrombolytic group were analyzed. Results As for 47 cases in systemic thrombolytic group, perimeter difference of thigh before versus after thrombolytic therapy was （7.72 ± 1.67） cm vs （3.05 ± 1.03） cm and perimeter difference of calf before versus after thrombolytic therapy was （4.35 ±0.84） cm vs （2.12±0.92） cm. As for 35 cases in catheter thrombolytic group, perimeter difference of thigh before versus after thrombolytic therapy was （7.86±2.23） cm vs （1.81 ±0.68） cm and perimeter difference of calf before versus after thrombolytic therapy was （4.24 ± 0.68） cm vs （1.56 ±0.38） cm. Limb detumescence rate and thrombolysis rate in perioperative period of catheter thrombolytic group was superior to systemic thrombolytic group, the difference was statistically significant （P〈 0.05）. Conclusions Popliteal venous catheter thrombolysis for LEDVT, is a safe and effective treatment, but the individualized treatment plan still need to be further studied.