机械性吸栓和接触性导管溶栓治疗下肢深静脉血栓形成的疗效对比分析

Comparison of efficacy analysis of percutaneous mechanical thrombectomy and catheter-directed thrombosis in the treatment of lower extremity deep vein thrombosis

目的比较机械性吸栓(PMT)和接触性导管溶栓(CDT)治疗下肢深静脉血栓形成(DVT)的临床效果。方法回顾性分析 2019年 6月至2022 年6月哈尔滨医科大学附属第一医院收治的125例急性中央型或混合型DVT患者的临床资料, 其中80例行AngioJet机械吸栓+下腔静脉滤器置入术(PMT组), 45例行CDT+下腔静脉滤器置入术(CDT组), 比较两组患者的围术期疗效及术后短期随访指标。结果 PMT组在住院时间、尿激酶用量、溶栓治疗时间方面低于CDT组, 差异均具有统计学意义[(5.3±0.8)d 比(7.0±1.0)d, t=10.600, P<0.01;(39.6±9.1)万U 比(126.0±32.4)万U, t=17.522, P<0.01;(1.0±0)d 比(2.1±0.5)d, t=13.681, P<0.01]。两组在不良事件发生率、血栓清除率、患肢周径差及短期随访的Villatla评分和视觉模拟评分, 差异均无统计学意义(P均>0.05)。结论 PMT和CDT在 DVT 患者的治疗中都有满意的术后效果和短期随访结果, PMT组住院时间和溶栓时间较短, 溶栓相关并发症较少。

Objective To compare the clinical effects of percutaneous mechanical thrombectom(PMT)and catheter-directed thrombosis(CDT)in the treatment of lower extremity deep venous thrombosis(DVT).Method A retrospective analysis was conducted on the clinical data of 125 patients with acute central or mixed-type DVT at the First Affiliated Hospital of Harbin Medical University from June 2019 to June 2022.Among them,80 patients who received AngioJet mechanical thrombectomy and inferior vena cava filter implantation were in the PMT group,and 45 patients who received CDT and inferior vena cava filter implantation were in the CDT group.The perioperative efficacy and postoperative follow-up indicators of the two groups were compared.Results The average hospitalization time,urokinase dosage,and thrombolysis treatment time in the PMT group were significantly lower than those in the CDT group,with statistical significance[(5.3±0.8)d vs(7.0±1.0)d,t=10.600,P<0.01;(396000±91000)U vs(1260000±324000)U,t=17.522,P<0.01;(1.0±0)d vs(2.1±0.5)d,t=13.681,P<0.01].There was no statistically significant difference between the two groups in the incidence of adverse events,thrombus clearance rate,difference in limb circumference before and after discharge,and Villatla score and visual analogue scale(VAS)score at 3-6 months of follow-up(P>0.05).Conclusion Both PMT and CDT have satisfactory postoperative results and short-term follow-up efficacy in the treatment of DVT patients.Among them,PMT can significantly shorten the hospital stay,thrombolysis time and reduce perioperative complications related to thrombolysis.