导管接触性溶栓治疗下肢深静脉血栓形成对症状改善及静脉再通的影响研究

Effect of catheter-directed thrombolysis on symptom improvement and venous recanalization in patients with lower extremity deep venous thrombosis

目的探讨导管接触性溶栓(CDT)治疗下肢深静脉血栓形成(DVT)对症状改善及静脉再通的影响。方法选取2020年5月至2022年6月西安市中心医院收治的DVT患者96例作为研究对象,采用抽签法随机分为观察组和对照组,每组48例。两组患者均给予基础治疗,在此基础上,对照组采用系统溶栓(ST)治疗,观察组采用CDT治疗。比较两组临床疗效、临床相关指标(包括溶栓时间、尿激酶用量及住院时间)、治疗前后肢体周径差、治疗前后血浆溶血磷脂酸(LPA)、同型半胱氨酸(Hcy)水平和静脉再通评分与并发症发生情况。结果与对照组比较,观察组总有效率高于对照组,差异有统计学意义(P<0.05)。观察组溶栓时间、尿激酶用量、住院时间均少于对照组,差异均有统计学意义(P<0.05)。治疗后14 d,两组各项肢体周径差均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。治疗后14 d,两组血浆LPA、Hcy水平、静脉再通评分均低于治疗前,且观察组静脉再通评分低于对照组,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CDT治疗DVT临床疗效更明显,能有效缩短溶栓时间,快速缓解患者临床症状、体征和恢复静脉再通。

Objective To investigate the effect of catheter-directed thrombolysis(CDT)on symptom improvement and venous recanalization in the treatment of lower extremity deep venous thrombosis(DVT).Methods A total of 96 patients with DVT admitted to Xi′an Central Hospital from May 2020 to June 2022 were selected as the research objects,and were randomly divided into observation group and control group by lottery method,with 48 cases in each group.Both groups were given basic treatment,on this basis,the control group was treated with systemic thrombolysis(ST),and the observation group was treated with CDT.The clinical efficacy,clinical related indicators(including thrombolysis time,urokinase dosage and length of hospital stay),limb circumference difference before and after treatment,plasma lysophosphatidic acid(LPA)and homocysteine(Hcy)levels before and after treatment,venous recanalization score and complications were compared between the 2 groups.Results Compared with control group,the total effective rate in observation group was higher than that in control group,and the difference was statistically significant(P<0.05).The thrombolytic time,the dosage of urokinase and the length of hospital stay in observation group were less than those in control group,and the differences were statistically significant(P<0.05).After 14 days treatment,the limb circumference differences of the 2 groups were lower than those before treatment,and observation group were lower than those of control group,and the differences were statistically significant(P<0.05).After 14 days treatment,the plasma levels of LPA and Hcy and venous recanalization score of the 2 groups were lower than those before treatment,and the venous recanalization score of observation group was lower than that of control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of complications between the 2 groups(P>0.05).Conclusion CDT is more effective in the treatment of DVT,which can effectively shorten the thrombolytic time,quickly relieve the clinical symptoms and signs of patients and restore venous recanalization.