经皮机械性血栓清除术治疗下肢深静脉血栓形成的研究进展

Advances of percutaneous mechanical thrombectomy in the treatment of lower extremity deep vein thrombosis

静脉血栓栓塞症发病率逐渐增加,即使是在标准抗凝治疗下,仍然有70%以上的患者会发生血栓形成后综合征(PTS),这将严重降低患者生活质量,增加经济负担。因此,快速去除血栓,恢复静脉通路,减少PTS的发生成为近年来临床关注的重点。目前的治疗方法有系统溶栓、导管接触性溶栓(CDT)、手术取栓、血栓抽吸、经皮机械取栓(PMT)等,其中PMT可通过不同物理方法快速清除血栓,减少溶栓药物的使用,虽然目前尚无高质量证据证明其相对于其他方式有更好的安全性及有效性,但PMT为临床医师提供了更多的选择,从而实现个体化医疗,获得最佳的临床效果。本文旨在对目前常见的PMT在原理、特点及局限性等方面进行综述。

The incidence of venous thromboembolism is gradually increasing.More than 70%of patients receiving standard anticoagulation treatment suffered from post-thrombotic syndrome(PTS),which will seriously reduce the quality of life and increase the economic burden.Therefore,rapid removal of thrombus,restoration of venous flow and reduce the incidence of PTS have become the focus of clinical research in recent years.The current treatment methods include systemic thrombolysis,catheter-directed thrombolysis(CDT),surgical thrombectomy,thrombus aspiration,percutaneous mechanical thrombectomy(PMT),et al.PMT can rapidly remove acute or subacute thrombus through different physical methods and reduce the use of thrombolytic drugs.Although there is no high-quality evidence to prove that PMT has better safety and effectiveness than other treatments,it provides more choices for clinicians to achieve the best clinical effects.This paper aims to summarize the basic principles,advantages and limitations of PMT.