应用AcoStream外周血栓抽吸系统联合置管溶栓治疗下肢深静脉血栓形成的临床价值

Clinical efficacy of AcoStream peripheral thrombus aspiration system combined with catheter-directed thrombolysis in treatment of lower extremity deep vein thrombosis

目的探讨应用AcoStream外周血栓抽吸系统联合置管溶栓治疗下肢深静脉血栓形成的安全性及有效性。方法回顾性分析2022年5至11月本院收治的16例急性下肢深静脉血栓形成患者,应用AcoStream外周血栓抽吸系统联合置管溶栓治疗,观察比较治疗前后患肢与健侧周径差、静脉通畅度评分、血栓清除等级、术中失血量等指标,随访评估采用Villalta评分。采用配对样本t检验和Wilcoxon符号秩和检验比较观察指标治疗前后的变化以评估疗效。结果入组16例均成功完成治疗,治疗前患健侧大腿和小腿的周径差分别为(3.69±0.97)、(3.34±0.75)cm,患侧静脉通畅度评分为8(7.25,9)分,治疗后患健侧大腿和小腿的周径差分别为(0.81±0.68)、(0.84±0.70)cm,患侧静脉通畅度评分1(0,1)分,差异均具有统计学意义(P均<0.001)。7例血栓Ⅲ级清除,9例血栓Ⅱ级清除,血栓抽吸过程中患者平均失血(133.1±12.0)ml。随访6个月,Villalta评分为0(0,1.75)分。结论AcoStream外周血栓抽吸系统联合置管溶栓治疗下肢深静脉血栓形成安全、有效,近期疗效满意,具有较高临床应用价值。

ObjectiveTo investigate the efficacy and safety of AcoStream peripheral thrombus aspiration system combined with catheter-directed thrombolysis in the treatment of lower extremity deep vein thrombosis.MethodsThe clinical data of 16 lower extremity deep vein thrombosis cases treated with AcoStream peripheral thrombus aspiration system combined with catheter-directed thrombolysis,admitted to the authors′hospital from May 2022 to November 2022,were retrospectively analyzed.The differences in circumferential diameter between the affected limb and the healthy side,venous patency score,thrombus clearance grade and intraoperative blood loss were observed and compared.The Villalta score was used during the follow up.Paired sample t-test and Wilcoxon rank sum test were used to compare the changes in the observed indicators before and after treatment to evaluate the efficacy.ResultsTreatment were successfully performed in all patients.Before treatment,the circumference differences between the affected and unaffected thighs and calves were(3.69±0.97)and(3.34±0.75)cm,respectively,the venous patency score of the affected side was 8(7.25,9)points.After treatment,the circumference differences between the affected and unaffected thighs and calves were(0.81±0.68)and(0.84±0.70)cm,respectively.The venous patency score of the affected side was 1(0,1)points,with statistically significant differences(P<0.001).GradeⅢthrombus clearance was achieved in 7 patients,gradeⅡthrombus clearance was achieved in 9 patients.The average blood loss during thrombus aspiration was(133.1±12.0)ml.Following up for 6 months,the Villalta score was 0(0,1.75)points.ConclusionAcostream peripheral thrombus aspiration system combined with catheter-directed thrombolysis is safe and effective for the treatment of lower extremity deep venous thrombosis,with satisfactory short-term efficacy and high clinical application value.