摘要
目的评价介入治疗急性大面积肺栓塞合并下肢深静脉血栓的临床疗效。方法选取本院收治的急性大面积肺栓塞合并下肢深静脉血栓患者30例。依就诊先后顺序随机分为两组。14例在下腔静脉滤器植入后采取导管祛栓联合管溶栓的患者为祛栓组,16例在下腔静脉滤器植入后采取全身静脉溶栓的患者为对照组,观察临床症状、体征、血流动力学改变、血管开通以及并发症情况。结果所有患者临床症状均明显缓解。术后1天祛栓组氧饱和度、动脉血氧分压和休克指数与对照组比较改善明显(P<0.01)。术后7天祛栓组健、患肢周径差,静脉通畅度评分和Miller评分与对照组比较显著降低(P<0.01)。祛栓组的显效率明显高于对照组(P<0.05),无严重手术并发症发生。结论介入治疗急性大面积肺栓塞合并下肢深静脉血栓是一种安全有效的方法。
Objective To evaluate the clinical efficacy of interventional procedure in treatment of acute massive pulmonary embolism （PE） with deep vein thrombosis （DVT） in lower extremities. Methods Totally 30 patients with acute massive PE and DVT in lower extremities were randomly divided into two groups in order of their admission time. Patients in the thrombus removal group （n= 14） received embolectomy of catheter and catheter-guided thrombolysis after inferior vena ca- va filter （IVCF） placement. Patients in the control group （n= 16） underwent systemic venous thrombolysis after IVCF placement. Clinical manifestations, physical sign, hemodynamie changes, the recanalization of obstructed blood vessels as well as the occurrence of complications were observed. Results All patients clinical symptoms were relieved after treat- ment. The oxygen saturation （SpO2）, arterial partial pressure of oxygen （PaO2） and shock index were significantly im- proved in the thromhus removal group on the first postoperative day compared with the control group （P〈0.01）. The difference in circumference of healthy and affected lower extremities, venous patency score and miller score were signifi- cantly decreased in the thrombus removal group on the seventh postoperative day compared with the control group （P〈 0.01）. The obvious effect rate of the thrombus removal group was obviously higher than that of the control group （P〈 0.05）, and no severe complications occurred. Conclusion Interventional therapy is a safe and effective technique for the treatment of acute massive PE with DVT in lower extremities.
出处
《中国介入影像与治疗学》
CSCD
北大核心
2016年第8期460-463,共4页
Chinese Journal of Interventional Imaging and Therapy
基金
河北省科技支撑计划项目(20122162)
关键词
肺栓塞
静脉血栓形成
介入治疗
Pulmonary embolism
Venous thrombosis
Interventional therapy
