Angiojet吸栓联合支架植入治疗急性深静脉血栓合并血栓性髂静脉压迫综合征的价值

Value of Angiojet thrombus aspiration combined with stent implantation in the treatment of acute deep vein thrombosis complicated with thrombotic iliac vein compression syndrome

目的:研究Angiojet吸栓联合支架植入治疗急性深静脉血栓(DVT)合并血栓性髂静脉压迫综合征(IVCS)的价值.方法:选择2018年1月~2020年1月本院收治的50例急性DVT合并血栓性IVCS患者作为研究对象,使用随机数表法将其分为观察组和对照组,各25例.观察组行Angiojet吸栓联合支架植入治疗,对照组置管溶栓联合支架植入治疗,随访12个月.观察治疗后临床疗效和患者临床结果(血栓清除等级、溶栓时间、尿激酶剂量、住院时间及治疗前后静脉通畅得分、患健侧大、小腿周径差),记录患者治疗前和治疗后1、6、12个月Villalta评分,观察并记录治疗后两组不良事件发生情况.结果:治疗后两组疗效无明显差异;治疗后两组静脉通畅评分和患健侧大、小腿周径差均有所降低;与对照组比较,观察组治疗后静脉通畅评分和患健侧大、小腿周径差均较低,溶栓时间、住院时间较短,使用尿激酶剂量较少;治疗后1、6、12个月,两组Villalta症状得分、体征得分和总分呈现下降趋势;治疗后两组不良事件发生情况无明显差异.结论:Angiojet吸栓联合支架植入治疗急性DVT合并血栓性IVCS具有较高的血栓清除率,能够改善静脉通畅情况、减少溶栓药物剂量和溶栓时间,节约住院成本,并具有较高的安全性,值得推广.

Objective To study the value of Angiojet thrombus aspiration combined with stent implantation in the treatment of acute deep vein thrombosis complicated with thrombotic iliac vein compression syndrome.Methods 50 patients with acute deep vein thrombosis combined with thrombotic iliac vein compression syndrome in our hospital from January 2018 to January 2020 were selected as the research objects,and they were randomly divided into observation group and control group,25 cases in each group.The observation group was treated with Angiojet thrombus aspiration combined with stent implantation,and the control group was treated with catheter thrombolysis combined with stent implantation.The patients were followed up for 12 months.The clinical efficacy and clinical results(thrombus clearance grade,thrombolytic time,urokinase dose,length of hospital stay,venous patency score before and after treatment,and the circumference difference of the affected side and leg)were observed.The Villaita score before treatment and 1,6,12 months after treatment were recorded.The occurrence of adverse events in the two groups after treatment was observed and recorded.Results After treatment,there was no significant difference between the two groups;After treatment,the venous patency score and the circumference difference of the affected side and the leg of the two groups were decreased,and the difference was statistically significant;After treatment,compared with the control group,the observation group had lower vein patency score,larger leg circumference difference,shorter thrombolysis time and hospitalization time,and less urokinase dosage;At 1,6 and 12 months after treatment,the Villaita symptom score,physical sign score and total score of the two groups showed a downward trend,and the difference was statistically significant;After treatment,there was no significant difference in the incidence of adverse events between the two groups.Conclusion Angiojet thrombus aspiration combined with stent implantation in the treatment of acute DVT complicated with thrombotic IVCS has higher throm bus clearance rate,can improve venous patency,reduce the dose of thrombolytic drugs and thrombolytic time,save the cost of hospitalization,and has higher safety,which is worthy of promotion.