置管溶栓术结合支架植入对急性下肢DVT患者血流畅通和血栓后综合征的影响

The effects of catheter thrombolysis combined with stent implantation on blood flow patency and post thrombotic syndrome in patients with acute DVT of the lower limbs

目的探讨置管溶栓术结合支架植入对急性下肢深静脉血栓(DVT)患者血流畅通和血栓后综合征的影响。方法选取104例急性下肢DVT患者,随机均分为联合组(置管溶栓术+支架置入)和溶栓组(置管溶栓术)。比较两组治疗前后静脉畅通率、下肢周径差、血液流变学指标,以及血栓后综合征(PTS)、并发症情况。结果联合组静脉畅通率高于溶栓组(P<0.05)。与治疗前比较,治疗后两组双侧大腿周径差、双侧小腿周径差随治疗时间延长逐渐下降,且联合组变化更为显著(P<0.05)。与治疗前比较,两组治疗后血液流变学指标均降低(P<0.05),但两组间比较差异无显著性(P>0.05)。随访2年,联合组发生PTS程度低于溶栓组(P<0.05)。治疗时两组并发症发生率比较差异无显著性(P>0.05)。结论置管溶栓术结合支架置入能更有效地再通急性下肢DVT患者静脉,降低PTS发生。

Aim To explore the effects of catheter thrombolysis combined with stent implantation on blood flow patency and post thrombotic syndrome in patients with acute deep vein thrombosis(DVT)of the lower limbs.Methods 104 patients with acute DVTs of the lower limbs were selected and randomly divided into a combination group(catheter thrombolysis+stent placement)and a thrombolysis group(catheter thrombolysis).The venous patency rate,lower limb circumference,hemorheological indicators,as well as post thrombotic syndrome(PTS)and complications between two groups before and after treatment were compared.Results The venous patency rate in the combined group was higher than that in the thrombolysis group(P<0.05).Compared with the situations before treatment,the bilateral thigh circumference difference and bilateral calf circumference difference of the two groups decreased over time after treatment,and the combined group showed more significant changes(P<0.05).Compared with the situations before treatment,the hemorheological indicators of both groups decreased after treatment(P<0.05),but there was no significant difference between the two groups(P>0.05).During a 2-year follow-up,the incidence of PTS in the combination group was lower than that in the thrombolysis group(P<0.05).There was no significant difference in the incidence of complications between the two groups during treatment(P>0.05).Conclusion Catheter thrombolysis combined with stent placement can more effectively recanalize the veins of acute DVT of lower limb in patients and reduce the incidence of PTS.