D-二聚体在下肢深静脉血栓形成导管溶栓过程中疗效评估的作用

Efficacy evaluation of plasma D-dimer in catheter-directed thrombectomy in deep venous thrombosis of lower extremities

目的探讨血浆D-二聚体在下肢深静脉血栓形成导管溶栓过程中疗效评估的作用。方法回顾性分析2016年1月到2018年8月蚌埠医学院第一附属医院血管外科收治的80例下肢深静脉血栓形成患者治疗过程中检测的血浆D-二聚体水平及深静脉造影的图像,分下肢深静脉导管溶栓治疗组(观察组,43例)和单纯外周静脉溶栓治疗组(对照组,37例)。主要观察指标为每天监测两组溶栓过程D-二聚体水平变化,并结合治疗前后的造影图片评估疗效。结果观察组和对照组术前血浆D-二聚体水平对比差异无统计学意义(t=1.47,P>0.05)。术后第1天起观察组升高幅度大于对照组,对比差异有统计学意义(P<0.05),至术后第8天两组对比差异无统计学意义(P>0.05);术后第9天恢复至术前水平,两组术前血浆D-二聚体水平差异无统计学意义(P>0.05)。造影检查证实观察组较对照组深静脉内血栓溶解更多,血管腔内造影剂充盈情况佳,两组静脉通畅评分分别为(4.74±1.54)分和(8.68±0.83)分,差异有统计学意义(t=4.55,P<0.05)。结论通过监测血浆D-二聚体评估下肢深静脉血栓形成导管溶栓过程中疗效是可行的。

Objective To explore the efficacy evaluation of plasma D-dimer in catheter-directed thrombectomy of deep venous thrombosis of lower extremities.Methods Retrospective analysis was performed on the plasma D-dimer level and images of deep vein angiography during the treatment of 80 patients who were diagnosed as deep venous thrombosis of lower extremities treated at the First Affiliated Hospital of Bengbu Medical College from January 2016 to August 2018.They were divided into the deep venous catheter-directed thrombectomy therapy group(the observation group,43 cases)and the system thrombolysis therapy group(the control group,37 cases).The main indicator was daily monitoring of changes in D-dimer levels during thrombolysis in the two groups,and the efficacy was evaluated with contrast images before and after treatment.Results The statistical significance was not found in plasma D-dimer level between the observation group and the control group before treatment(t=1.47,P>0.05).The increase of the observation group was greater than that of the control group from the 1 st day after operation,and the difference was statistically significant(P<0.05).The difference between the two groups was not statistically significant until the 8 th day after the operation(P>0.05).On the 9 th day after the operation,the level of plasma D-dimer returned to the preoperative level(P>0.05).Contrast examination confirmed that the observation group had more deep vein thrombolysis than the control group,and the vascular lumen was well filled with contrast agent.The scores of vein patency in the two groups were(4.74±1.54)and(8.68±0.83),respectively,with statistically significant difference(t=4.55,P<0.05).Conclusion It is feasible to monitor the plasma D-dimer in the treatment of deep venous thrombosis of lower limb during thrombolysis.