重组人尿激酶原经置管溶栓治疗急性下肢深静脉血栓患者的有效性及安全性

Efficacy and safety of recombinant human prourokinase by catheter thrombolysis in the treatment of acute lower extremity deep venous thrombosis

目的研究重组人尿激酶原(rhPro-UK)经置管溶栓治疗急性下肢深静脉血栓(DVT)的有效性及安全性,以期为急性DVT患者的治疗提供参考依据。方法选取2021年1月至2022年12月收治的160例急性DVT患者为研究对象,按照电脑随机编号法将其分为参照组及试验组,各80例。两组均接受基础治疗与植入下腔静脉滤器。在此基础上,参照组接受静脉滴注尿激酶溶栓治疗,试验组接受rhPro-UK经置管溶栓治疗。比较两组的临床疗效、不良事件发生情况、患肢腿围及深静脉血栓形成后综合征(PTS)发生情况。结果试验组的治疗总有效率为86.25%,高于参照组的50.00%,差异具有统计学意义(P<0.05)。两组住院期间肺栓塞、出血及恶心呕吐的发生率比较,差异无统计学意义(P>0.05)。治疗后,两组的患肢大腿、小腿腿围均小于治疗前,且试验组小于参照组,差异具有统计学意义(P<0.05)。试验组的PTS总发生率为17.50%,低于参照组的32.50%,差异具有统计学意义(P<0.05)。结论rhPro-UK经置管溶栓治疗急性DVT患者的有效性及安全性均较佳,且能改善患肢肿胀情况,降低PTS发生风险。

Objective To study the efficacy and safety of recombinant human prourokinase(rhPro-UK)in the treatment of acute lower extremity deep venous thrombosis(DVT)by catheter thrombolysis,in order to provide reference for the treatment of patients with acute DVT.Methods A total of 160 patients with acute DVT admitted from January 2021 to December 2022 were selected as the research objects.According to the computer random numbering method,the patients were divided into reference group and experimental group,with 80 cases in each group.Both groups received basic treatment and implantation of inferior vena cava filter.On this basis,the reference group received intravenous infusion of urokinase thrombolytic therapy,and the experimental group received rhPro-UK by catheter thrombolysis therapy.The clinical efficacy,incidence of adverse events,leg circumference of affected limbs and incidence of post thrombotic syndrome(PTS)were compared between the two groups.Results The total effective rate of treatment in the experimental group was 86.25%,which was higher than 50.00%in the reference group,and the difference was statistically significant(P<0.05).There were no significant difference in the incidences of pulmonary embolism,bleeding and nausea and vomiting between the two groups during hospitalization(P>0.05).After treatment,the thigh and calf circumference of the affected limbs in the two groups were smaller than those before treatment,and those in the experimental group were smaller than the reference group,and the differences were statistically significant(P<0.05).The total incidence of PTS in the experimental group was 17.50%,which was lower than 32.50%in the reference group,and the difference was statistically significant(P<0.05).Conclusion The rhPro-UK by catheter thrombolysis in the treatment of acute DVT patients has better efficacy and safety,and it can improve the swelling of the affected limb and reduce the risk of PTS.