腘静脉置管溶栓术治疗非急性期深静脉血栓21例临床分析

Clinical analysis of catheter directed thrombolysis for non-acute deep venous thrombosis of lower limbs

目的 初步探讨静脉置管溶栓术治疗非急性期深静脉血栓的临床应用价值。方法 对 2 1例亚急性和慢性深静脉血栓患者 ,在 B超引导下行静脉置管溶栓术治疗。结果 所有患者均置管成功 ,其中 3例未能通过髂静脉 ;出院前影像学检查示 ,完全再通 4例 ,达到 B型再通 15例 ,其中 5例接受髂静脉球囊扩张术 ,并继续置管溶栓 ,实现完全再通 4例 ;其余 2例为 A型再通。结论 亚急性期甚至慢性期的血栓是可以溶解的 ,不能完全再通的病例 ,常存在血管狭窄或压迫 ,尤其是髂静脉 ,需结合球囊扩张血管成形术。

Objective To investigate the feasibility of catheter directed thrombolysis for subacute and chronic deep venous thrombosis of lower limbs.Methods 21 cases of non acute deep venous thrombosis of lower limbs were treated with catheter directed thrombolysis and the popliteal puncture was under ultrasound guidance for the venous access.Results The procedures of the popliteal puncture,catheter and guidewire exchanges were successful in all 21 cases,and 3 cases were not permitted passing through iliac veins.Clinical manifestations were alleviated in all 21 cases,completely cured in 5 cases, significantly improved in 14 cases,improved in 2 cases.Implied by imaging examination before discharged from hospital,there were 4 cases whose venous patency were restored completely,15 cases whose venous patency were restored for ⅡB type.Angioplasty were applied in 5 cases,2 cases whose venous patency were restored for ⅡA type.Conclusions The subacute and chronic thrombosis can be lysed by catheter directed thrombolysis, blood flow can be restored.Angioplasty may be applied in the patients whose venous patency are not restored completely.