机械性血栓抽吸术治疗髂股静脉血栓形成

摘要

目的:探讨机械性血栓抽吸治疗髂股静脉血栓形成的临床疗效.方法:回顾性分析236例急性髂股深静脉血栓(DVT)患者的临床资料.均经腱侧股静脉预防性放置下腔静脉滤器,在数字减影血管造影(DSA)透视下患侧股静脉插入12～14 F大腔鞘管,50 mL注射器负压抽吸髂股静脉血栓.112例合并髂静脉狭窄或闭塞患者,行经皮血管成形术(PTA)和支架植入；术后给予肝素抗凝.结果:出院时膝上、下15cm处腱、患侧周径差分别降为(1.34±0.57)cm和(0.93±0.42)cm,与入院时比较差异有统计学意义(t=19.37、23.99,P均＜0.05)；随访36个月,随访率97.88％(231/236).术后水肿、色素沉着和溃疡等后遗症发生率12.99％ (30/231)、8.23％ (19/231)和0；随访疗效优92.21％(213/231).支架植入患者随访均通畅.结论:机械性血栓抽吸治疗髂股DVT疗效显著,并发症少,住院周期短,能够明显降低后遗症的发生率.%Objectives To discuss the clinical effect of mechanical aspiration thrombectomy for acute Iliofemoral deep venous thrombosis, methods: The clinical data of 236 patients with acute iliofemoral DVT from April 2005 to January 2009 were analyzed retrospectively. All the patients were implanted inferior vena cava filter, then inserted an 12 ~ 14 F catheter to the femoral vein of af-fected limbs to aspirate thrombus by 50 mL syringe under DSA. 112 cases who had common iliac vein stenosis or occlusion took methods of PTA and stenting. A small dose heparin was used to an-ticoagulation after operation. Results: The circumference differences of knee-joint's above and below 15 cm of healthy and affected limbs at discharge were(1.34 ± 0.57)cm and(0.93 ± 0.42)cm , the difference had statistical significance compared with at admission(t=19.37, 23.99; both P<0.05). The morbidity of edema, pigmentation and ulcer were 12.99% (30/231), 8.23% (19/231) and O.The follow up of clinical effect was excellent that took up 92.21%. Patients were followed up for stent placement were unobstructed. Conclusions: The clinical effect of mechanical aspiration thrombectomy for acute iliofemoral DVT is remarkable, has fewer complication, and the hospitaliza-tion duration is shorter,can obviously decrease the incidence of sequelae.