加压静脉滴注尿激酶并中药治疗下肢深静脉PTS的临床研究

摘要

Objective To investigate the effect of urokinase by pressed intravenously guttae of combined with Chinese herbal medicine into the dorsal vein in treatment of post-thrombotic syndrome (PTS) in deep vein of lower extremity. Methods 140 patients with PTS in lower extremity were randomly divided into three groups. 60 patients in therapy group were treated with urokinase pressed intravenous drip into the dorsal vein of the affected foot and Chinese herbal medicine was given for oral use. 40 patients in control group 1 were treated with urokinase intravenous drip into the dorsal vein of the foot routinely and Chinese herbal medicine for oral use. 40 patients in control group 2 were treated with urokinase pressed intravenous drip into the dorsal vein of the affected foot. The changes of the main symptoms, signs, the fibrinogen, villaltas score and the vascular color Doppler ultrasound imaging of the three groups were observed. The safety of the therapy was also observed and a 3-year follow-up was made. Results The total efficacy rates of therapy group, control group 1 and control group 2 were 98.3% , 70.0% and 75.0% respectively. The differences between the therapy group and the others were statistically significant (P 0.05); after treatment, villaltas score, wound volume, affected limb circumference, fibrinogen, ultrasonic testing rod blood flow number showed statistically significant difference between the therapy group and the two control groups (P<0.01). The three groups had no significant adverse reactions. After being followed up for 3 years, the recurrence rates of the therapy group was significantly lower than that of the two control groups (P <0.01). Conclusion The affected limb pressurizing and dorsum of the foot venous infusion of urokinase and Chinese medicine in treatment of deep vein PTS is safe, effective with a low recurrence rate.%目的 探讨患肢加压足背静脉滴注尿激酶并中药治疗下肢深静脉血栓形成后综合征(post-thrombotic syndrome,PTS)的效果.方法 将下肢深静脉PTS 140例随机分为3组,即患肢加压足背静脉滴注尿激酶并中药治疗60例(治疗组)、尿激酶常规足背静脉滴注并中药治疗40例(对照1组)、患肢加压足背静脉滴注尿激酶治疗40例(对照2组).观察3组治疗前后主要症状体征、纤维蛋白原、Villalta's评分、患肢血管彩色多普勒超声的变化,进行治疗安全性观察和3年随访.结果 治疗组、对照1组、对照2组总有效率分别为98.3％、70.0％、75.0％,治疗组与对照l组及对照2组比较差异有统计学意义(P＜0.01),对照组间比较差异无统计学意义(P＞0.05)；治疗后Villalta's评分、创面容积、患肢周径、血纤维蛋白原、超声检测棒状血流条数治疗组与对照1组及对照2组比较,差异均有统计学意义(P＜0.01).3组均无明显不良反应,随访3年,治疗组复发率均低于对照组,差异有统计学意义(P＜0.01).结论 患肢加压足背静脉滴注尿激酶并中药治疗下肢深静脉PTS安全、有效,复发率低.