Angiojet机械吸栓术结合抗凝治疗下肢深静脉血栓的疗效观察

Observation on efficacy of Angiojet mechanical thrombectomy combined with anticoagulation in the treatment of lower extremity deep vein thrombosis

目的观察Angiojet机械吸栓术结合抗凝治疗下肢深静脉血栓的疗效。方法选取平湖市第一人民医院2017年11月至2019年1月收治的48例下肢深静脉血栓患者为研究对象,按照患者自愿原则,实施Angiojet机械吸栓术结合抗凝治疗20例(20条肢体)为观察组,实施单纯抗凝治疗28例(28条肢体)为对照组。观察并比较两组患者治疗前后下肢周径差(患健侧大腿周径差、患健侧小腿周径差)、临床疗效、治疗后静脉通畅情况以及治疗1年后复发率、Villalta评分、静脉临床严重程度评分(VCSS)。结果治疗前,两组患者下肢周径差比较,差异均无统计学意义(均P>0.05);治疗后,两组患者下肢周径差均明显减小(均P<0.05),且观察组小于对照组(均P<0.05)。与对照组比较,观察组疗效更优(P<0.05),平均静脉通畅率更高(P<0.05),静脉通畅程度评分更低(P<0.05)。治疗1年后,两组患者均未发生严重的出血、肺动脉栓塞等并发症或死亡,观察组复发率、Villalta评分、VCSS均低于对照组(均P<0.05)。结论Angiojet机械吸栓术结合抗凝治疗下肢深静脉血栓疗效确切且安全性高,可有效改善患者预后。

Objective To observe the efficacy of Angiojet mechanical thrombectomy combined with anticoagulation in the treatment of lower extremity deep vein thrombosis.Methods Forty-eight patients with lower extremity deep vein thrombosis from November 2017 to January 2019 in the First People's Hospital of Pinghu were selected.According to the voluntary principle of patients,20 patients(20 limbs)were treated with Angiojet mechanical thrombectomy combined with anticoagulation,and 28 patients(28 limbs)were treated with anticoagulant alone.The lower extremity circumference difference(circumference difference of thigh and calf of the affected limb and the healthy limb)before and after treatment,clinical efficacy,venous patency after treatment and recurrence rate,villalta score and venous clinical severity score(VCSS)after 1 year of treatment were observed and compared between the two groups.Results Before treatment,there were no statistical significance in circumference differences of lower limbs between the two groups(all P>0.05).After treatment,the circumference differences of lower limbs in both groups were significantly decreased(all P<0.05),and the difference values of observation group were smaller than those of control group(all P<0.05).Compared with the control group,the clinical efficacy in observation group was better(P<0.05),the mean venous patency rate was higher(P<0.05),and the venous patency score was lower(P<0.05).After 1 year of treatment,neither group of patients had severe bleeding,pulmonary embolism,or other complications or death.The recurrence rate,Villalta score and VCSS of observation group were lower than those of control group(all P<0.05).Conclusion Angiojet mechanical thrombectomy combined with anticoagulation for lower extremity deep vein thrombosis is effective and safe,and can effectively improve the prognosis.