血栓抽吸控制系统机械吸栓治疗急性下肢动静脉血栓及肺动脉栓塞的效果

Effects of mechanical thrombectomy with thrombus aspiration control system in the treatment of acute lower extremity arteriovenous thrombosis and pulmonary embolism

目的探讨血栓抽吸控制系统机械吸栓治疗急性下肢动静脉血栓及肺动脉栓塞的效果。方法选择2019年6月至2021年6月宜春市人民医院收治的40例急性下肢深静脉血栓形成(DVT)、急性肺动脉栓塞、急性下肢动脉栓塞患者作为研究对象,按照随机数字表法分为试验组和对照组,各20例。对照组给予导管接触溶栓治疗,试验组给予血栓抽吸控制系统机械吸栓治疗。比较术后两组DVT患者尿激酶用量、溶栓效果、住院时间、溶栓前后患健侧大小腿周径差和并发症发生情况差异,比较急性肺动脉栓塞患者溶栓术后血栓清除情况、尿激酶用量、导管留置时间、并发症发生情况以及溶栓前后D-二聚体、血红蛋白、肾功能(血清肌酐)、动脉血氧饱和度(SPO_(2))的差异,观察急性下肢肺动脉栓塞患者溶栓术后疗效差异。结果试验组DVT患者溶栓术后尿激酶用量低于对照组,差异有统计学意义(P<0.05)。试验组DVT患者住院时间短于对照组,差异有统计学意义(P<0.05)。两组DVT患者溶栓前大小腿周径差比较,差异无统计学意义(P>0.05);两组DVT患者溶栓后大小腿周径差均小于本组术前,差异有统计学意义(P<0.05);两组DVT患者术后大小腿周径差比较,差异无统计学意义(P>0.05)。试验组DVT患者溶栓疗效高于对照组,差异有统计学意义(P<0.05)。试验组急性肺动脉栓塞患者血栓清除率高于对照组,差异有统计学意义(P<0.05)。试验组急性肺动脉栓塞患者尿激酶用量低于对照组,差异有统计学意义(P<0.05)。试验组急性肺动脉栓塞患者导管留置时间短于对照组,差异有统计学意义(P<0.05)。两组急性肺动脉栓塞患者溶栓前和溶栓后D-二聚体、血红蛋白、血清肌酐和SPO_(2)水平组间比较,差异均无统计学意义(P>0.05);两组急性肺动脉栓塞患者溶栓前后血红蛋白、血清肌酐和SPO_(2)水平组内比较,差异均无统计学意义(P>0.05);两组急性肺动脉栓塞患者溶栓后D-二聚体水平低于溶栓前,差异有统计学意义(P<0.05)。两组DVT和急性肺动脉栓塞患者并发症总发生率比较,差异无统计学意义(P>0.05)。试验组急性下肢动脉栓塞患者溶栓疗效高于对照组,差异有统计学意义(P<0.05)。结论血栓抽吸控制系统机械吸栓治疗急性下肢动静脉血栓及肺动脉栓塞具有更好的效果,能有效减少溶栓药物用量并有助于患者预后。

Objective To explore the effects of mechanical thrombectomy with thrombus aspiration control system in the treatment of acute lower extremity arteriovenous thrombosis and pulmonary embolism.Methods A total of 40 patients with acute lower extremity deep venous thrombosis(DVT),acute pulmonary embolism and acute lower extremity arterial embolism in Yichun People′s Hospital from June 2019 to June 2021 were selected as research objects,and they were divided into test group and control group according to the random number table method,with 20 cases in each group.The control group was treated with catheter-directed thrombolysis,and the test group was treated with mechanical thrombectomy with thrombus aspiration control system.The Urokinase dosage,thrombolytic effect,hospital stay,circumference differences of thigh and shank of affected side and healthy side before and after thrombolysis and occurrence of complications were compared between the two groups of patients with DVT after surgery.The thrombus clearance status,Urokinase dosage,catheter indwelling time,occurrence of complications after thrombolysis and D-dimer,hemoglobin,renal function(serum creatinine),arterial oxygen saturation(SPO_(2))before and after thrombolysis were compared among patients with acute pulmonary embolism.The efficacy after thrombolysis was observed among patients with acute lower extremity arterial embolism.Results After thrombolysis,the Urokinase dosage of patients with DVT in test group was less than that of control group,the difference was statistically significant(P<0.05).The hospital stay of patients with DVT in test group was shorter than that in control group,the difference was statistically significant(P<0.05).There were no statistically significant differences in the circumference differences of thigh and shank between the patients with DVT of two groups before thrombolysis(P>0.05).After thrombolysis,the circumference differences of thigh and shank in the two groups of patients with DVT were lower than those before surgery,the differences were statistically significant(P<0.05).There were no statistical differences in postoperative circumference differences of thigh and shank between the two groups of patients with DVT(P>0.05).The thrombolytic efficacy of patients with DVT in test group was higher than that in control group,the difference was statistically significant(P<0.05).The thrombus clearance rate of patients with acute pulmonary embolism in test group was higher than that in control group,the difference was statistically significant(P<0.05).The Urokinase dosage of patients with acute pulmonary embolism in test group was less than that in control group,the difference was statistically significant(P<0.05).The catheter indwelling time of patients with acute pulmonary embolism in test group was shorter than that in control group,the difference was statistically significant(P<0.05).There were no statistical differences in the levels of D-dimer,hemoglobin,serum creatinine and SPO_(2) between the patients with acute pulmonary embolism in two groups before and after thrombolysis(P>0.05).The differences in the levels of D-dimer,hemoglobin,serum creatinine and SPO_(2) were not statistically significant in the patients with acute pulmonary embolism of two groups before and after thrombolysis(P>0.05).The D-dimer level of the patients with acute pulmonary embolism in two groups after thrombolysis was lower than that before thrombolysis,the difference was statistically significant(P<0.05).There was no statistical significance in the total incidence rate of complications between the patients with DVT and acute pulmonary embolism in two groups(P>0.05).The thrombolytic efficacy of patients with acute lower extremity arterial embolism in test group was higher than that in control group,the difference was statistically significant(P<0.05).Conclusion Mechanical thrombectomy with thrombus aspiration control system has a good efficacy in the treatment of acute lower extremity arteriovenous thrombosis and pulmonary embolism.It can effectively reduce the dosages of thrombolytic drugs and contribute to the prognosis of patients.