经导管取栓联合置管溶栓治疗下肢深静脉血栓的临床疗效

Clinical efficacy of transcatheter thrombectomy combined with catheter placement thrombolysis in the treatment of lower extremity deep venous thrombosis

目的 探讨经导管取栓联合置管溶栓治疗下肢深静脉血栓形成(LDVT)的临床疗效。方法 收集2019年3月至2023年2月安庆市第一人民医院收治的76例LDVT患者的临床资料,按照治疗方法的不同将其分为药物组(n=38,采用保守药物治疗)与介入组(n=38,采用经导管取栓联合置管溶栓治疗)。比较两组患者临床指标,治疗前、治疗后7d健患侧大腿围差值、小腿围差值及凝血功能指标,评估临床疗效与血栓清除效果,统计两组患者治疗后并发症发生情况。结果 介入组患者治疗时间、症状改善时间、住院时间均短于药物组患者,差异均有统计意义(P﹤0.05)。治疗后,两组患者健患侧大腿围差值、小腿围差值均小于本组治疗前,且介入组患者均小于药物组患者,差异均有统计学意义(P﹤0.05)。治疗后,两组患者凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)均较本组治疗前延长,纤维蛋白原(FIB)、D-二聚体(D-D)水平均较本组治疗前下降,且介入组患者PT、APTT均长于药物组患者,FIB、D-D水平均低于药物组患者,差异均有统计学意义(P﹤0.05)。介入组患者血栓清除效果、临床疗效均优于药物组患者,差异均有统计学意义(P﹤0.05)。两组患者治疗后并发症发生率比较,差异无统计学意义(P﹥0.05)。结论 经导管取栓联合置管溶栓治疗LDVT可获得更为理想的临床疗效与血清清除效果,并可缩短溶栓时间,提高治疗安全性。

Objective To investigate the clinical effect of transcatheter thrombectomy combined with catheter placement thrombolysis in the treatment of deep vein thrombosis of lower extremity(LDVT).Method Clinical data of 76 LDVT patients admitted to the Anqing First People's Hospital from March 2019 to February 2023 were collected.According to different treatment methods,they were divided into drug group(n=38,treated by conservative drug therapy)and interventional group(n=38,treated by transcatheter thrombectomy combined with catheter placement thrombolysis).The clinical indicators,thigh circumference difference,calf circumference difference and coagulation function index of the affected side were compared between the two groups before treatment and 7 days after treatment.Clinical efficacy and thrombus clearance effect were evaluated,and complications were statistically analyzed between the two groups after treatment.Result The treatment time,symptom improvement time,and hospitalization time of the intervention group were shorter than those of the drug group,the differences were statistically significant(P<0.05).After treatment,the difference in thigh circumference and calf circumference between the healthy and affected sides of the two groups were smaller than those before treatment,and the intervention group of those were smaller than the drug group,the differences were statistically significant.After treatment,the prothrombin time(PT)and activated partial thromboplastin time(APTT)of two groups were prolonged compared to before treatment,while the levels of fibrinogen(FIB)and D-dimer(D-D)decreased compared to before treatment.In addition,the PT and APTT in the intervention group were longer than those in the drug group,and the FIB and D-D levels were lower than those in the drug group,the differences were statistically significant(P<0.05).The thrombus clearance effect and clinical efficacy of the intervention group were better than those of the drug group,the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of postoperative complications between the two groups of patients(P>0.05).Conclusion Transcatheter thrombectomy combined with catheter placement thrombolysis can obtain more ideal clinical efficacy and serum clearance effect in the treatment of LDVT,it can shorten the thrombolysis time and improve the treatment safety.