摘要
目的:对比单纯抗凝(anticoagulation,AC)与接触性导管溶栓联合抗凝(catheter-directed thrombolysis,CDT)治疗下肢深静脉血栓(DVT)的效果。方法:选取本院2011年5月-2013年9月收治的139例DVT患者,根据随机数字表法分为AC组(n=66)与CDT+AC组(n=73),观察两组溶栓效果、不良反应、血栓后综合症(PTS)和生活质量情况。结果:两组患者在治疗期间和治疗结束后均无严重的不良反应发生,其中CDT组有2例穿刺处血肿,1例血尿,2例牙龈出血;AC组有1例牙龈出血,1例血肿。与AC组相比,CDT+AC组患者中Ⅰ级溶解的人数显著降低(60.61%vs 9.59%)(P<0.05),Ⅲ级溶解的人数显著升高(7.57%vs 49.31%)(P<0.05)。随访期间,两组的PTS发病率均呈逐渐增高趋势,但无1例患者出现重度PTS。CDT+AC组患者在第12个月和18个月时的PTS发病率均较AC组显著降低(17.81%vs 33.33%,24.66%vs 43.94%)(P<0.05)。与AC组相比,CDT+AC组在第6个月、12个月及18个月时生理职能和活力评分均显著升高(P<0.05)。结论:接触性导管溶栓联合单纯抗凝治疗下肢深静脉血栓形成疗效显著,安全性高,而且有利于患者生活质量的改善。
Objective： To investigate the therapeutic efficacy of anticoagulation（AC） and its combination with catheterdirected thrombolysis（CDT） for deep venous thrombosis of lower extremities. Methods： One hundred and thirty-nine patients with deep venous thrombosis of early lower extremities treated in our hospital from May 2011 to September 2013 were selected and randomly divided into the AC group（n = 66） and CDT ＋ AC group（n = 73）. The thrombolytic effects,adverse reactions,post-thrombotic syndrome（ PTS） and quality of life were evaluated. Results： There were no serious adverse events during treatment and after treatment in the 2 groups. Hematomas in 2 cases and gross hematuria in 3 cases were observed in the CDT ＋ AC group. The gums bleed or gross hematuria in 3 cases were observed in the AC group.Compared with the AC group,the number of grade Ⅰ thrombolysis in CDT ＋ AC group decreased significantly（60. 61%vs 9. 59%）（P〈 0. 05）,and the number of grade Ⅲ thrombolysis increased significantly（7. 57% vs 49. 31%）（ P〈 0. 05）. During follow-up,the incidence of PTS in both groups showed increase year by year,and none of the patients had severe PTS. The incidence PTS in CDT ＋ AC group at 12 months and 18 months were lower than those of AC group（17. 81% vs 33. 33%,24. 66% vs 43. 94%）（P〈 0. 05）. Compared with the AC group,the scores of physiological role and vitality in CDT ＋ AC group at 6 months,12 months and 18 months were higher（P〈 0. 05）. Conclusion： Catheterdirected thrombolysis combined with AC therapy can promote the mitigation of clinical symptoms in patients with DVT of lower extremities and is beneficial to promoting the life quality of patients.
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2017年第5期1509-1513,共5页
Journal of Experimental Hematology
关键词
下肢深静脉血栓
单纯抗凝
接触性导管溶栓
血栓后综合症
安全性
生存质量
deep venous thrombosis
anticoagulation
catheter-directed thrombolysis
post - thrombotic syndrome
safety
life quality
