导管接触性溶栓与机械血栓清除治疗急性下肢深静脉血栓的临床疗效对比

Comparison of the clinical efficacy of catheter contact thrombolysis and mechanical thrombectomy in the treatment of acute lower extremity deep vein thrombosis

目的探讨急性下肢深静脉血栓(DVT)的机械血栓清除的临床应用效果。方法回顾性分析2018年1月—2020年12月宿迁市第一人民医院接受DVT手术治疗(导管接触性溶栓A组、机械血栓清除B组)患者,术后随访6个月,采用下肢深静脉血管超声评估下肢深静脉及髂静脉血流通畅情况。结果A组和B组在大、小腿消肿率差异无统计学意义(P>0.05);B组住院时间短于A组,住院总费用及耗材费用均高于A组差异有统计学意义(P<0.05);A组和B组溶栓清除分级差异无统计学意义(P>0.05);两组患者支架通畅率、Villalta评分及并发症发生率差异无统计学意义(P>0.05)。结论机械血栓清除和导管接触性溶栓治疗急性DVT差异性小,但机械血栓清除可缩短住院时间,有助于患者尽快康复,但其可增加医疗资源消耗。

Objective To study the clinical effects of mechanical thrombectomy for acute lower extremity deep vein thrombosis acute deep vein thrombosis.Methods A retrospective analysis was conducted on the patients with lower limb deep vein thrombosis who were admitted to Suqian First People's Hospital from January 2018 to December 2020 treated with either catheter contact thrombolysis(group A)or mechanical thrombectomy(group B).The patients were followed up for 6 months after the surgery.Ultrasonic evaluation of the lower limb deep vein and iliac venous blood flow were conducted.Results There was no statistically significant difference between group A and group B in terms of swelling reduction rate in thighs and calfs(P>0.05).The hospitalization time in group A were significantly higher than those in group B,The total hospitalization expenses and consumables expenses in group A were significantly lower than those in group B(P<0.05).There was no significant difference in thrombolysis clearance grading between group A and group B(P>0.05).There was no significant difference in stent patency rate and Villalta score between the two group(P>0.05).Conclusion Mechanical thrombus clearance and catheter contact thrombolysis have little difference in the treatment of acute lower limb deep vein thrombosis,mechanical thrombectomy can shorten the hospitalization time and help patients recover as soon as possible,but it can increase the consumption of medical resources.