摘要
目的:分析股腘静脉游离血栓的治疗效果.方法:回顾性分析2018年10月—2021年6月解放军联勤保障部队第九二〇医院收治的163例股腘静脉游离血栓形成患者的临床资料,其中男115例,女48例;左下肢78例,右下肢85例;急性期127例,亚急性期32例,慢性期4例.所有患者均通过彩超确诊.15例患者入院前出现症状性肺栓塞.其中行外周溶栓治疗24例,行下腔静脉滤器置入+溶栓导管治疗16例,滤器置入+外周溶栓123例.所有患者治疗期间均给予抗凝治疗.结果:163例患者中,脑出血死亡1例,因骨折术后多器官功能衰竭死亡1例,因骨折术后肺动脉栓塞出现意识丧失而自动出院1例,消化道出血1例.159例患者出院时游离血栓完全溶解142例.其中急性期123例,血栓溶解率100%;亚急性期19例,血栓溶解率59.4%;慢性期4例游离血栓均未溶解.置入滤器139例患者,18例未取出滤器,其中5例滤器捕获大块血栓.出院后长期(>6个月)口服华法林,随访12~36个月,17例患者残留游离血栓完全溶解,无一例患者出现新的游离血栓.结论:急性期股腘静脉游离血栓脱落风险较大,滤器置入+导管溶栓或滤器置入+外周溶栓治疗股腘静脉急性期游离血栓安全有效.
Objective To investigate the security and treatment effectiveness of non-adherent thrombosis in femoropopliteal venous segments.Methods Retrospective analysis of clinical data from 163 patients with free thrombosis of the femoral and popliteal veins admitted to the 920th Hospital of Joint Logistic Support Force of PLA from October 2018 to June 2021,including 115 males and 48 females.78 cases in the left lower limb and 85 cases in the right lower limb.127 cases were in the acute phase,32 cases were in the subacute phase,and 4 cases were in the chronic phase.All patients were diagnosed through color ultrasound.Fifteen patients experienced symptomatic pulmonary embolism before admission.Among them,24 cases underwent peripheral thrombolysis treatment,16 cases underwent inferior vena cava filter placement+thrombolysis catheter treatment,and 123 cases underwent filter placement+peripheral thrombolysis.All patients were treated with anticoagulant therapy during the treatment period.Results Among 163 patients,1 died from cerebral hemorrhage,1 died from multiple organ failure after fracture surgery,1 was discharged automatically due to consciousness loss caused by pulmonary embolism after fracture surgery,and 1 suffered from gastrointestinal bleeding.Out of 159 patients,142 had complete dissolution of free blood clots upon discharge.Among them,123 cases were in the acute phase,with a 100%thrombus dissolution rate,19 cases were in the subacute phase,with a thrombolysis rate of 59.4%,Four cases of free thrombus in the chronic phase did not dissolve.Out of 139 patients who had filters inserted,18 did not remove the filters,of which 5 filters captured large thrombi.After long-term(>6 months)oral administration of warfarin after discharge,followed up for 12-36 months,17 patients had complete dissolution of residual free thrombus,and no patient developed new free thrombus.Conclusions The risk of acute free thrombus detachment in the femoral and popliteal veins is high.The combination of filter placement and catheter thrombolysi
作者
梅百强
方伟
尹存平
郭曙光
邱天
苏宏斌
MEI Baiqiang;FANG Wei;YIN Cunping;GUO Shuguang;QIU Tian;SU Hongbin(Department of Vascular Surgery,the 920th Hospital of Joint Logistic Support Force of PLA,Kunming,Yunnan 650032,China)
出处
《医药前沿》
2024年第4期15-17,共3页
Journal of Frontiers of Medicine
