精准溶栓及机械性血栓清除术在急性深静脉血栓形成治疗中的应用

Clinical application of precision thrombolysis and percutaneous mechanical thrombectomy in the treatment of acute deep venous thrombosis

目的探讨目前急性下肢深静脉血栓形成(DVT)溶栓及机械性血栓清除治疗不同方法选择,对比精准溶栓(血管内封闭导管)与机械性血栓清除治疗急性DVT的效果及安全性。方法回顾分析2016年1月至10月收治的24例下肢骨折合并急性下肢DVT患者临床资料,其中A组12例给予精准导管溶栓(血管内封闭导管,TAPAS导管),B组12例给予机械性血栓清除(Aspirex旋吸导管),评价两组患者治疗期间的静脉通畅率及肢体消肿率情况。结果技术成功率100%。两组患者静脉通畅率分别为(84.33±4.74)%、(86.0±2.89)%,肢体消肿率分别为(73.83±15.49)%、(76.50±17.17)%,差异无统计学意义(P>0.05)。结论使用血管内封闭导管精准溶栓以及使用机械性血栓清除治疗急性DVT效果明显,安全可靠,两者在静脉通畅率及肢体消肿率方面疗效相当。

Objective To investigate the efficacy and safety of precision thrombolysis and the percutaneous mechanical thrombectomy in the treatment of acute deep venous thrombosis（DVT）. Methods The clinical date of 24 lower extremities fracture patients with acute DVT were retrospectively analyzed from January to October 2016. Of all patients, 12 cases were treated with the TAPAS catheter thrombolysis（Group A）, and the other 12 cases were treated with percutaneous mechanical thrombectomy（Aspirex Catheter,Group B）. The deep vein thrombectomy rate and the limb swelling remission rate were evaluated between two groups. Results the technical success rate was 100%. The swelling and pain of the affected limbs were relieved after operation in all patients. The deep vein thrombectomy rate of the two groups were（84.33±4.74）% and（86.0 ±2.89）%（P =0.443）, while the limb swelling remission rate were（73.83 ±15.49）% and（76.50±17.17）%（P =0.266）. Conclusion The precision thrombolysis and the percutaneous mechanical thrombectomy are effective and safe in the treatment of the acute DVT in patients with lower extremities fracture.