置管溶栓与外周溶栓对急性期下肢深静脉血栓的疗效比较

Comparing the outcomes of catheter-directed thrombolysis and peripheral thrombolysis for acute deep wenous thrombosis at lower extremity

目的:比较急性期下肢深静脉血栓(DVT)患者分别行置管溶栓及外周溶栓的治疗效果。方法:选取2016年1月~2018年1月弋矶山医院血管外科收治的急性期DVT患者,共40例。随机分为两组,一组为置管溶栓组20例,其中行腘静脉置管溶栓18例,股静脉置管溶栓2例;另一组20例患者为外周溶栓组,其中大隐静脉留置针13例,自足背静脉留置针7例。通过检测患者下肢肿胀缓解时间、下肢周径变化程度及术后并发症比较两组患者的治疗效果。结果:溶栓治疗前3 d,置管溶栓组疗效优于外周静脉组,溶栓治疗7 d后,两组疗效差异无统计学意义。随访6~24个月,两组患者血栓复发率及并发症差异无统计学意义。结论:置管溶栓对于急性期DVT的早期疗效优于外周溶栓,远期疗效两者差异无统计学意义。

Objective:To compare the clinical outcomes of catheter-directed thrombolysis(CDT)and peripheral thrombolysis in the treatment of patients with acute deep venous thrombosis(DVT)at lower extremities.Methods:Forty patients with acute DVT treated in our department were included from January of 2016 to 2018,and divided into CDT group and peripheral thrombolysis group(n=20 for each group).Of the 20 patients in DVT group,18 underwent catheter placement via popliteal vein,and 2 via femoral vein.Treatment effects were compared between groups regarding the time of relieved swelling,changes of circumferential diameter of limbs and incidence of postoperative complications.Results:Three days before thrombolytic therapy,The efficacy of CDT group was better than that of peripheral vein group,and there was no significant difference between the two groups after 7 days.There was no significant difference in recurrence rate and complications between the two groups after 6-24 months follow-up.Conclusion:CDT appears superior to peripheral thrombolysis for acute DVT at lower extremities,yet the long-term effect remains no significant difference.