重组人尿激酶原联合AngioJet机械血栓清除系统治疗早期下肢深静脉血栓的疗效与安全性评价

Efficacy and safety evaluation of recombinant human Pro urokinase combined with AngioJet Ultra thrombectomy system in the treatment of early deep venous thrombosis of lower extremities

目的评价重组人尿激酶原(rhPro-UK)联合AngioJet机械血栓清除系统治疗早期下肢深静脉血栓(DVT)的疗效与安全性。方法回顾分析2018年1月至2019年12月在甘肃省人民医院血管外科采用rhPro-UK联合AngioJet机械血栓清除系统治疗的23例早期下肢DVT患者的临床资料。根据治疗前后患肢静脉通畅评分及治疗前、治疗后3 d患肢与健肢周径差评价疗效,根据并发症的发生情况评价治疗方法的安全性。结果与治疗前比较,治疗后3 d患肢与健肢周径差及治疗后患肢静脉通畅评分均明显降低,差异有统计学意义(t=25.749,P<0.01;t=23.165,P<0.01);23例患者中有9例患者术后发生血红蛋白尿,发生率为39.13%,24~48 h后复查恢复正常,未发生穿刺部位出血、肺栓塞、肾功能损害、动静脉瘘等并发症。结论rhPro-UK联合AngioJet机械血栓清除系统治疗早期下肢DVT疗效显著且安全,值得临床推广应用。

Objective To evaluate the efficacy and safety of recombinant human Pro urokinase(rhPro-UK)combined with AngioJet Ultra thrombectomy system in the treatment of early deep venous thrombosis(DVT)of lower extremities.Methods A retrospective study was undertaken to analyze the clinical data of 23 patients with early DVT of lower extremities treated with rhPro-UK combined with AngioJet Ultra thrombectomy system in the vascular surgery of Gansu Provincial the People’s Hospital from January 2018 to December 2019.According to the venous patency score of affected limb before and after treatment,along with the efficacy evaluation by the circumference difference between the affected limb and healthy limb before treatment and after treatment for 3 days,and according to the occurrence of complications,the safety of the therapeutic method was evaluated.Results Compared with those before treatment,the circumference difference between the affected limb and healthy limb after treatment for 3 days and the venous patency score of the affected limb after treatment all significantly decreased,and the difference was statistically significant(t=25.749,P<0.01;t=23.165,P<0.01);among the 23 patients,9 patients developed hemoglobinuria,the incidence was 39.13%.Checked after 24 to 48 hours,the patients recovered to normal.There were no complications such as puncture site hemorrhage,pulmonary embolism,renal function impairment,arteriovenous fistula etc.Conclusion It has marked efficacy and safety to use rhPro-UK combined with AngioJet Ultra thrombectomy system in the treatment of early DVT of lower extremities,which deserves clinical promotion and application.