文章摘要
董训忠,秦金保,崔 健,石 亿,周汝航.经皮导管接触溶栓腔内治疗与标准抗凝治疗用于急性下肢深静脉血栓的临床效果比较[J].,2019,19(18):3589-3593
经皮导管接触溶栓腔内治疗与标准抗凝治疗用于急性下肢深静脉血栓的临床效果比较
Comparison of the Therapeutic Effects of Catheter-directed Thrombolysis and Standard Anticoagulation for the Lower Extremity Deep Vein Thrombosis
投稿时间:2018-12-28  修订日期:2019-01-25
DOI:10.13241/j.cnki.pmb.2019.18.042
中文关键词: 急性下肢深静脉血栓形成  导管溶栓  腔内治疗
英文关键词: Acute deep vein thrombosis  Catheter-directed thrombolysis  Endovascular treatment
基金项目:国家自然科学基金项目 (81601621)
作者单位E-mail
董训忠 亳州市人民医院血管外科 安徽 亳州236800 dongxunzhong@foxmail.com 
秦金保 上海交通大学医学院附属第九人民医院血管外科 上海 200011  
崔 健 亳州市人民医院血管外科 安徽 亳州236800  
石 亿 亳州市人民医院血管外科 安徽 亳州236800  
周汝航 亳州市人民医院血管外科 安徽 亳州236800  
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中文摘要:
      摘要 目的:分析和比较经皮导管接触溶栓腔内治疗与单纯标准抗凝治疗急性下肢深静脉血栓形成的临床效果的安全性。方法:回顾性分析93例中央型(髂股静脉)和混合型(全下肢深静脉)深静脉血栓患者临床资料,根据治疗方法的不同分为导管溶栓治疗组(试验组)65例、单纯抗凝治疗组(对照组)28例,比较两组患者治疗后患肢消肿率、下肢深静脉血栓的溶栓率及并发症的发生率。结果:治疗后,试验组患者患肢大腿消肿率[(83.03±4.53) %]显著高于对照组[(50.42±7.41)%](P<0.05);患肢小腿消肿率[(76.48±8.24) %]亦显著高于对照组(54.95±8.14)% (P<0.05)。试验组患者下肢深静脉血栓溶栓有效率为92.31%(60/65),显著高于对照组[14.29%(4/28)](P<0.05)。随访半年后,试验组患者下肢血管的通畅率为90.67%(57/65),PTS率为7.69%(5/65);而对照组患者下肢血管的通畅率为21.42%(6/28),PTS率为14.28%(4/28)。试验组血管通畅率明显高于对照组(P<0.05),而PTS发生率明显低于对照组(P<0.05)。两组患者并发症发生率比较差异无明显统计学意义(P>0.05)。结论:经皮导管接触溶栓腔内治疗急性中央型和混合型下肢深静脉血栓的短期疗效优于单纯抗凝治疗,且两种方法的安全性相当。
英文摘要:
      ABSTRACT Objective: To analyze and compare the clinical effect and security of catheter-directed thrombolysis (CDT) and standard anticoagulationin the treatment of acute deep venous thrombosis (DVT). Methods: The clinical data of 93 cases of acute central type DVT (iliofemoral) and Entire Limb DVT inpatients were retrospectively analyzed. According to the treatment, the patients were divided into 65 cases of catheter-directed thrombolysis group(trial group) and 28 cases of standard anticoagulation treatment group(control group). The limb swelling remission rate, deep vein thrombolysis rate and complication rate were compared between the two groups. Results: For the central type DVT and the entire limb DVT, the thigh swelling remission rate of trial group had (83.03±4.53) % was significantly higher than that of the control group (50.42±7.41) %; and the calf swelling remission rate of trial group was (76.48±8.24) %, which was also significantly higher than that of the control group (54.95±8.14)%, (P<0.05). For the central type DVT and the entire limb DVT, the thrombolysis rate of deep vein in the trial group was 92.31% (60/65), which was significantly higher than that of the control group [14.29%(4/28)](P<0.05). After half a year of follow-up, the patency rate of trial group was 90.67% (57/65), and the incidence of PTS was 7.69% (5/65), but the patency rate of control group was 21.42% (6/28), the incidence of PTS was 14.28% (4/28). The complications rate of the two groups showed no obvious statistical difference. Conclusion: The short-term clinical effect of catheter-directed thrombolysis treatment for the acute central type DVT (iliofemoral) and the entire limb DVT is better than that of standard Anticoagulation and the security of catheter-directed thrombolysis (CDT) is equal to that of standard anticoagulation treatment.
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