摘要
目的:探讨不同剂量尿激酶在经导管溶栓治疗急性下肢深静脉血栓形成(DVT)中的有效性及安全性。方法:使用经导管溶栓治疗DVT,并按尿激酶用量、给药频率将患者分组,比较溶栓效果及随访结果差异。结果:100例患者治疗前后凝血指标结果显示尿激酶溶栓对纤维蛋白原(Fg)、血浆凝血酶原时间(PT)、D-二聚体的影响较大(P<0.05)。尿激酶剂量及频次分别为12.5万U/d、25万U/d、50万U/d,血栓溶解率分别是(44.65±6.29)%、(54.10±6.74)%及(55.01±7.85)%,12.5万U/d用量血栓溶解率较低,差异均有统计学意义(P<0.05)。尿激酶相同用量患者,2次/d的血栓溶解率高于1次/d(P<0.05)。出院后随访,患者一般情况渐渐明显改善,且随访期间各指标总体评分渐改善(P<0.05)。出院后1年肢体沉重、肿胀感基本消失。结论:尿激酶每日用量在25万U能达到较高的血栓溶解率和低的出血风险,且增加每日尿激酶给药频率,可以提高血栓溶解率。
Objective: To study the efficacy and safety of urokinase in the catheter-directed thrombolysis(CDT) treatment of acute deep venous thrombosis(DVT)of lower extremity. Methods:Patients enrolled were treated with CDT, and divided into different groups by different urokinase dose and frequency. Results: the coagulation indicators of 100 patients before and after treatment showed that Urokinase thrombolysis more affect Fg, PT, D-D dimer. With the increase of the frequency and dose urokinase, 125 kU/d, 250 kU/d, 500 kU/d, thrombolysis rate increases(44.65±6.29)%,(54.10±6.74)%,(55.01±7.85)% respectively, and the differences were statistically significant(P〈0.05). As the follow-up time was prolonged, the general condition of the patients gradually improved, and the overall scores of each indicator gradually improved during the follow-up period.Conclusion: Dosage of urokinase daily in 250 kU can achieve a high rate of thrombolysis and low bleeding risk, and increase the daily urokinase dosing frequency, can raise rate of thrombolysis.
作者
董波
王暐
王夕栩
汪恒
王珏
龚亦群
洪彪
DONG Bo;WANG Wci;WANG Xi-xu;WANG Hcng;WANG Juc;GONG Yi-qun;HONG Biao(Department of Vascular Surgery,Tongren Hospital,Shanghai Jiaotong University School of Medicine(Shanghai 200336,China)
出处
《中国现代普通外科进展》
CAS
2018年第5期360-364,共5页
Chinese Journal of Current Advances in General Surgery
基金
上海市长宁区科学技术委员会项目(CNKW2013Z09)
上海交通大学医学院附属同仁医院院级项目(TR201411)
关键词
下肢深静脉血栓形成
尿激酶
腔内技术
导管溶栓
Deep vein thrombosis
Urokinase
Endovenous technique
Catheter-directedthrombolysis