AngioJet机械吸栓联合导管接触溶栓在急性下肢深静脉血栓形成中的疗效分析

Evaluation of percutaneous mechanical thrombectomy by AngioJet aspiration catheter combined with catheter-directed thrombolysis in the treatment of lower extremity deep vein thrombosis

目的评价Angio Jet机械吸栓(percutaneous mechanical thrombectomy,PMT)联合导管接触溶栓(catheterdirected thrombolytic,CDT)在急性下肢深静脉血栓形成中的临床疗效。方法回顾性分析2016年1月至9月于克拉玛依市中心医院治疗的26例急性下肢深静脉血栓形成患者的临床资料,根据治疗方式的不同,分为PMT+CDT组(12例)和CDT组(14例),比较2组患者的临床疗效。结果 PMT+CDT组:Ⅲ级溶栓8例(66.7%),Ⅱ级溶栓3例(25.0%),Ⅰ级溶栓1例(8.3%);CDT组:Ⅲ级溶栓7例(50.0%),Ⅱ级溶栓5例(35.7%),Ⅰ级溶栓2例(14.3%)。PMT+CDT组较CDT组溶栓效果更好(P<0.05),PMT+CDT组的尿激酶用量及溶栓时间较CDT组减少(P<0.05),2组均未出现严重并发症。结论 Angio Jet PMT+CDT治疗急性下肢深静脉血栓形成较单纯CDT具有更好的溶栓效果,PMT+CDT治疗能更好地改善临床症状,同时具有尿激酶使用量少、溶栓时间短等优点。

Objective To evaluate the clinical efficacy of lower extremity deep vein thrombosis underwent percutaneous mechanical thrombectomy(PMT) by Angio Jet aspiration catheter combined with catheter-directed thrombolysis(CDT). Methods A retrospective analysis of the clinical data of 26 patients with lower extremity deep venous thrombosis treated in Karamay Central Hospital from January to September 2016 was made. The patients were divided into two groups according to therapy method: PMT + CDT group(n=12) and CDT group(n=14). Results In PMT+CDT group, complete thrombolysis was found in 8 cases(66.7%) with grade Ⅲ, 3 cases(25.0%) with grade Ⅱ and 1 case(8.3%) with gradeⅠ; in CDT group, it was 7(50.0%), 5(35.7%) and 2(14.3%), respectively. The difference of thrombolytic effects was significant between the two groups(P <0.05). The dosage of urokinase and thrombolysis time in PMT+CDT group was less than those in CDT group(P<0.05). Conclousion Compare with CDT treatment, Angio Jet PMT + CDT has a better thrombolysis effect. Angio Jet PMT + CDT can better improve the clinical symptoms, and has the advantages of less dosage of urokinase and shorter thrombolysis time.