摘要
目的：比较大腔导管取栓与单纯溶栓对急性混合型下肢深静脉血栓形成（LEDVT）的疗效。方法：回顾性分析11年间收治的458例急性混合型LEDVT患者的临床与随访资料。其中327例（A组）接受大腔导管血栓抽吸术,另131例（B组）接受尿激酶系统溶栓治疗。结果：A组术中无严重并发症发生,B组治疗中2例因出血而危及生命。平均住院时间A组6.5 d,B组9.5 d（P〈0.05）;治愈率A组94.8%,B组37.4%（P〈0.05）。术后36~48个月,双下肢膝下15 cm处周径差A组为（0.53±0.42）cm,B组为（1.42±1.35）cm（P〈0.05）;水肿、色素沉着、溃疡等发生率,A组分别为27.83%,13.15%和0,B组分别为55.73%,83.97%和9.16%（均P〈0.05）;A组静脉通畅率为90.83%,瓣膜功能正常率为73.09%,均明显高于B组（37.41%和15.27%）（均P〈0.05）;A组和B组总有效率分别为100%和71.76%（P〈0.05）。结论：大腔导管取栓对急性混合型下肢深静脉血栓形成的疗效优于单纯溶栓,尤其在保护静脉瓣膜功能方面更为明显。
Objective： To compare the clinical efficacies of large-lumen catheter thrombus aspiration and thrombolytic treatment for mixed type of acute lower extremity deep venous thrombosis （DVT）. Methods： The clinical and follow-up data of 458 patients with acute mixed type of lower extremity DVT admitted over 11 years were retrospectively analyzed. Of the patients, 327 cases （group A） underwent large- lumen catheter thrombus aspiration, and the other 131 cases （group B） received systemic thrombolytic therapy with urokinase. Results： No severe complication occurred in group A during operation, while in group B, life-threatening bleeding occurred in 2 patients during thrombolytic therapy. The average length of hospital stay for patients in group Awas 6.5 d and in group B was 9.5 d （P〈0.05）, and the cure rate in group A and group B was 94.8% and 37.4%, respectively （P〈0.05）. During 36-48 months follow-up period, the difference between the diameter of the two legs at 15 cm below knee joint was （0.53-＋0.42） cm in group A and （ 1.42-＋ 1.35） cm in group B （P〈0.0S）; the incidence of edema, skin pigmentation, and ulceration were 27.83%, 13.15% and 0 in group A, and 55.73%, 83.97% and 9.16% in group B, respectively （all P〈0.0S）; the vein patency rate and rate of normal functioning valves were 90.8396 and 73.09% in group Aj both of which were significantly higher than those in group B （37.41% and15.27%） （both P〈0.0S）; the overall effective rate in group A and group B was 100% and 71.76%, respectively （P〈0.0S）. Conclusion： Large-lumen catheter thrombus aspiration has better efficacy than thrombolytic therapy for acute mixed type of lower extremity DVT, especially in the aspect of venous valves protection.
出处
《中国普通外科杂志》
CAS
CSCD
北大核心
2012年第12期1505-1509,共5页
China Journal of General Surgery
