下腔静脉滤器+导管接触性溶栓+髂静脉支架治疗下肢深静脉血栓的临床研究

Clinical Study of Inferior Vena Cava Filter+Catheter-directed Thrombolysis+Iliac Vein Stent in the Treatment of Lower Extremity Deep Venous Thrombosis

目的探讨下腔静脉滤器、导管接触性溶栓联合髂静脉支架治疗下肢深静脉血栓的临床效果。方法选取2020年5月—2023年5月济南北城医院收治的96例下肢深静脉血栓患者为研究对象。依据手术治疗方式不同将患者分为两组,各48例。对照组采取下腔静脉滤器、导管接触性溶栓治疗,观察组采取下腔静脉滤器、导管接触性溶栓联合髂静脉支架治疗。比较两组治疗效果、消肿效果、静脉通畅效果、凝血功能、生活质量。结果观察组治愈率为93.75%(45/48),高于对照组的79.17%(38/48),差异有统计学意义(χ^(2)=4.359,P<0.05)。治疗后,观察组静脉通畅评分、大腿周径、小腿周径低于对照组,大腿及小腿的消肿率高于对照组,差异有统计学意义(P均<0.05)。治疗后,观察组凝血酶原时间长于对照组,纤维蛋白原水平低于对照组,差异有统计学意义(P均<0.05)。治疗后,观察组静脉功能不全-生活质量/症状评分高于对照组,差异有统计学意义(P均<0.05)。结论下腔静脉滤器、导管接触性溶栓联合髂静脉支架治疗在下肢深静脉血栓患者中应用效果良好,可促使患肢肿胀消退,恢复血流通畅。

Objective To investigate the clinical effect of inferior vena cava filter,catheter contact thrombolysis combined with iliac vein stent in the treatment of deep venous thrombosis of lower extremity.Methods A total of 96 patients with lower extremity deep venous thrombosis admitted to Jinan Beicheng Hospital from May 2020 to May 2023 were selected as the research objects.According to the different surgical treatment methods,the patients were divided into two groups,48 cases in each group.The control group was treated with inferior vena cava filter and catheter contact thrombolysis,while the observation group was treated with inferior vena cava filter and catheter contact thrombolysis combined with iliac vein stent.The therapeutic effect,detumescence effect,venous patency effect,coagulation function and quality of life were compared between the two groups.Results The cure rate of the observation group was 93.75%(45/48),which was higher than 79.17%(38/48)of the control group,and the difference was statistically significant(χ^(2)=4.359,P<0.05).After treatment,the venous patency score,thigh circumference and calf circumference of the observation group were lower than those of the control group,and the swelling rate of the thigh and calf were higher than those of the control group,and the differences were statistically significant(all P<0.05).After treatment,the prothrombin time of the observation group was longer than that of the control group,and the level of fibrinogen was lower than that of the control group,and the differences were statistically significant(both P<0.05).After treatment,the Venous Insufficience-quality of Life/Symptom score of the observation group were higher than those of the control group,and the differences were statistically significant(both P<0.05).Conclusion The application of inferior vena cava filter,catheter-directed thrombolysis combined with iliac vein stent in the treatment of patients with lower extremity deep venous thrombosis is effective,which can promote the swelling of the affected limb to subside and restore blood flow patency.