下肢深静脉血栓形成165例的治疗分析

Treatment of lower extremty deep venous thrombosis in 165 patients

目的 观察下肢深静脉血栓形成 (DVT)患者手术取栓和药物溶栓治疗的疗效。方法对 16 5例 (175侧 )下肢DVT患者进行总结。其中 6 4例采用Fogarty导管取栓 ,10 1例采用药物溶栓治疗。结果 全组 96例患者得到随访 ,随访率为 5 8 2 % ,随访时间 7～ 2 18个月 ,平均 71个月。 44例为手术取栓 ,5 2例为药物溶栓。随访发现症状完全消失取栓组占 2 0 5 % (9/4 4) ,高于溶栓组 13 5 %(7/5 2 ) ,溶栓组肢体发生浅静脉曲张和皮肤色素沉着占 5 0 5 % ,取栓组为 31 8%。结论 手术取栓可以保护部分患者下肢的主干深静脉瓣膜 。

Objective To evaluate the therapeutic results of embolectomy and thrombolysis for lower extremity deep vein thrombosis in 165 patients. Methods Embolectomy was undertaken with Fogarty catheter in 64 patients while 101 patients were treated by thrombolytic agents. Results Ninety-six cases (58.2%) were followed-up, ranging from 7 months to 218 months with an averge of 71 months including 44 cases undergoing embolectomy and 52 cases receiving thrombolytic agents. Symptoms disappeared in 20.5% of patients in embolectomy group and in 13.5% in thrombolytic group.In embolectomy group,the superficial varicoses and derma pigmentation in lower extremity appeared in 31.8% of patients,while in thrombolytic group the signs appeared in 50.5% of patients, respectively.Conclusions Embolectomy protecting the valve of deep trunk vein in some patients helps to reduce later complications of lower extremity deep venous thrombosis.