Angiojet机械性血栓清除术联合导管接触性溶栓治疗急性下肢深静脉血栓形成患者的效果

Effects of Angiojet mechanical thrombectomy combined with catheter-directed thrombolysis in patients with acute deep venous thrombosis of the lower extremities

目的:探讨Angiojet机械性血栓清除术(PMT)联合导管接触性溶栓(CDT)治疗急性下肢深静脉血栓形成(LEDVT)患者的效果。方法:回顾性分析2017年11月至2020年11月该院收治的90例LEDVT患者的临床资料,根据治疗方法不同将患者分为对照组与观察组各45例。对照组采用单独CDT治疗,观察组在CDT基础上联合PMT治疗。比较两组治疗3 d后溶栓效果、治疗7 d后患肢消肿率、溶栓时间、尿激酶用量、住院时间及并发症发生情况。结果:治疗3 d后,观察组溶栓有效率(88.89%)和Ⅲ级占比(84.44%)均明显优于对照组的溶栓有效率(62.22%)和Ⅲ级占比(42.22%),差异有统计学意义(P<0.05);治疗7 d后,观察组小腿消肿率和大腿消肿率高于对照组,溶栓时间、住院时间短于对照组,尿激酶用量小于对照组,差异均有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:PMT联合CDT治疗LEDVT患者能提高溶栓效果,缩短溶栓时间和住院时间,减少尿激酶用量,加快下肢消肿,效果优于单用CDT治疗。

Objective:To explore effects of Angiojet mechanical thrombectomy(PMT)combined with catheter-directed thrombolysis(CDT)in patients with acute deep venous thrombosis of the lower extremities(LEDVT).Methods:The clinical data of 90 patients with LEDVT admitted to our hospital from November 2017 to November 2020 were retrospectively analyzed.According to the different treatment methods,these patients were divided into control group and observation group,45 cases in each group.The control group was treated with single CDT,while the observation group was treated with PMT on the basis of CDT.The thrombolytic effect 3 days after the treatment,the swelling reduction rate of the affected limb 7 days after the treatment,the thrombolysis time,the dosage of urokinase,the hospitalization time and the incidence of complications were compared between the two groups.Results:3 days after the treatment,the effective rate of thrombolysis(88.89%)and the proportion of grade Ⅲ(84.44%)in the observation group were significantly better than those in the control group of 62.22% and 42.22%,and the differences were statistically significant(P<0.05).7 days after the treatment,the calf swelling reduction rate and thigh swelling reduction rate in the observation group were higher than those in the control group;the thrombolysis time and hospitalization time in the observation group were shorter than those in the control group;the dosage of urokinase was lower than that in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:PMT combined with CDT in the treatment of the LEDVT patients can improve the thrombolysis effect,shorten the thrombolysis time and the hospitalization time,reduce the dosage of urokinase,and accelerate the lower extremity swelling reduction.Moreover,it is superior to single CDT treatment.