经胫前静脉入路导管溶栓术对急性下肢深静脉血栓患者疗效、并发症及尿激酶用量的影响

Effects of catheter embolization via anterior tibial vein approach on efficacy, complications and urokinase dosage in patients with acute deep venous thrombosis of lower extremities

目的探讨急性下肢深静脉血栓患者经胫前静脉入路导管溶栓术后对临床疗效、并发症、尿激酶用量的影响。方法选取我科2017年2月-2020年2月急性下肢深静脉血栓患者84例为研究对象,按随机数字表法分为两组,对照组42例行腘静脉置管溶栓治疗,观察组42例行经胫前静脉入路导管溶栓术,1周后,对比两组患者溶栓前后下肢周径差、血栓清除分级及血栓形成后综合征(PTS)发生情况、并发症发生率及尿激酶用量。结果溶栓后,观察组患者大腿小腿周径差较对照组降低,差异有统计学意义(P<0.05);观察组患者血栓清除分级除I级、III级例数与对照组比较差异无统计学意义(P>0.05)外,II级较对照组例数少,差异有统计学意义(P<0.05);观察组PTS发生率与对照组比较差异无统计学(P>0.05);观察组并发症总发生率较对照组低,差异有统计学意义(P<0.05);观察组总尿激酶用量较对照组少,差异有统计学意义(P<0.05)。结论经胫前置管溶栓术,相较于腘静脉溶栓术,能够提升临床疗效,改善患者下肢肿胀,提升血栓清除率,缓解PTS症状,有效改善并发症症状,降低并发症发生率,减少尿激酶用量,提升患者生存质量及预后。

Objective To investigate the clinical efficacy, complications and urokinase dosage of patients with acute deep venous thrombosis of lower extremities after catheter embolization via tibial vein approach.Methods Our department in February 2017-February 2020,84 cases of patients with acute lower extremity deep vein thrombosis as the research object, is divided into two groups according to random number table method, the control group of 42 routine popliteal venous catheter thrombolysis treatment, the observation group of 42 routine via pretibial venous catheter RongShuanShu into the road, after 1 week, compared two groups before and after thrombolysis in patients with lower limb week difference size and grade of thrombus removal and thrombosis syndrome(PTS)before and after the situation, the incidence of complications and dosage of urokinase.Results After thrombolysis, the difference of the circumference of thighs and legs in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05).In the observation group, there was no statistically significant difference in the number of patients with grade I and III compared with the control group(P>0.05),and the number of patients with grade II was less than that of the control group, with statistically significant difference(P<0.05).There was no significant difference in the incidence of PTS between the observation group and the control group(P>0.05).The total incidence of complications in the observation group was lower than that in the control group, and the difference was statistically significant(P<0.05).The total amount of urokinase in the observation group was less than that in the control group, and the difference was statistically significant(P<0.05).Conclusion Compared with popliteal vein thromboembolic surgery, tibial anterior catheter can improve clinical efficacy, improve lower limb swelling, improve thrombotic clearance rate, relieve PTS symptoms, effectively improve complication symptoms, reduce the incidence of complications, reduce the amount of urokinase, and improve the quality of life and prognosis of patients.