利伐沙班对机械性血栓清除联合支架置入术后急性下肢深静脉血栓形成患者远期通畅率的影响

Effect of rivaroxaban on long-term patency rate of patients with acute deep venous thrombosis of lower limbs after percutaneous mechanical thrombectomy combined stent implantation

目的探讨利伐沙班对机械性血栓清除(PMT)联合支架置入术后急性下肢深静脉血栓形成(DVT)患者远期通畅率的影响。方法收集2018年3月至2019年3月宁夏医科大学总医院治疗的95例急性下肢DVT患者的临床资料。统计所有患者术前和术后1个月的Villalta评分,术后3、6、9、12、24个月支架通畅率,术后24个月不同服药时间的患者支架内血栓发生率。结果术后1个月,95例患者的Villalta评分低于术前,差异有统计学意义(P<0.05);术后3、6、9、12、24个月时的一期通畅率为97.9%、92.6%、87.2%、86.1%、85.1%。服用利伐沙班,67例≥6个月,27例<6个月;服用时间≥6个月患者的通畅率高于服用时间<6个月患者通畅率,差异有统计学意义(P<0.05)。结论PMT联合支架置入术后急性下肢DVT患者远期通畅率较好,术后Villalta评分明显改善,同时长期服用利伐沙班可降低支架内血栓形成,应当重视患者术后药物的治疗作用。

Objective To investigate the effect of rivaroxaban on long-term patency rate of patients with acute deep venous thrombosis(DVT)after percutaneous mechanical thrombectomy(PMT)combined stent implantation.Method Clinical data of 95 patients with acute lower limb DVT treated in General Hospital of Ningxia Medical University from March 2018 to March 2019 was collected and Villalta scores of all patients before and 1 month after operation,stent patency rate 3,6,9,12 and 24 months after operation and incidence of stent thrombosis 24 months after operation in patients with different medication time were counted.Result One month after operation,Villalta score of 95 patients was lower than that before operation,the difference was statistically significant(P<0.05).The primary patency rates 3,6,9,12 and 24 months after operation were 97.9%,92.6%,87.2%,86.1%and 85.1%,respectively.67 cases took rivaroxaban≥6 months and 27 cases<6 months.The patency rate of patients with medication time≥6 months was higher than that of patients with<6 months(P<0.05).Conclusion The long-term patency rate of patients with acute lower extremity DVT after PMT combined stent implantation is good with improved postoperative Villalta scores.Long-term rivaroxaban can reduce stent thrombosis,and the effect of postoperative drugs should be emphasized.