尿激酶溶栓联合球囊成形术治疗下肢深静脉血栓疗效观察

摘要

目的 探讨尿激酶溶栓联合球囊成形术治疗下肢深静脉血栓(LEDVT)的临床疗效.方法 选择2013年6月至2015年12月期间我院心血管内科收治的38例LEDVT患者为研究对象,根据随机数表法随机分为观察组(n=19)和对照组(n=19),对照组患者给予低分子肝素+华法林抗凝治疗,观察组患者则在此基础上应用尿激酶溶栓联合球囊成形术治疗,出院时比较两组患者的临床疗效及出血并发症发生率.结果 出院时观察组患者的膝上及膝下健患侧周径差分别为(1.18±0.46)cm和(0.75±0.14)cm,明显小于对照组的(1.74±0.52)cm和(0.98±0.28)cm,且观察组静脉通畅改善率为(47.31±16.47)%,大于对照组的(19.67±4.25)%,差异均有统计学意义(P<0.05);观察组患者随访期间血栓后综合征(PTS)发生率为5.26%,明显低于对照组的26.32%,差异有统计学意义(P<0.05);两组患者的出血并发症发生率比较差异无统计学意义(P>0.05).结论 在抗凝治疗的基础上应用尿激酶溶栓联合球囊成形术治疗下肢深静脉血栓具有确切的疗效和较好的安全性,且可显著降低PTS的发生率.%Objective To investigate the clinical efficacy of urokinase thrombolysis combined with balloon an-gioplasty for the treatment of lower extremity deep venous thrombosis (LEDVT). Methods Thirty-eight patients with LEDVT in Guangzhou Huadu District People's Hospital from June 2013 to December 2015 were divided into observa-tion group (n=19) and control group (n=19) according to the random number table method. The patients in the control group received anticoagulation therapy (low molecular weight heparin+Hua Falin);meanwhile, the patients in the obser-vation group were treated urokinase thrombolysis combined with balloon angioplasty on the basis of that therapy in the control group. At discharge, the clinical curative effect and the incidence of hemorrhagic complication between two groups were compared . Results At discharge, the differences in the circumference above and below the knee between the affected and unaffected side of the patients in the observation group were (1.18±0.46) and (0.75±0.14) cm, respective-ly, which were significantly less than those in the control group (1.74 ± 0.52) and (0.98 ± 0.28) cm (P<0.05). And the im-provement rate of venous patency in the observation group was (47.31±16.47)%, which was higher than that in the con-trol group (19.67 ± 4.25)%, showing the significant difference (P<0.05). During the follow-up period, the incidence rate of post thrombotic syndrome (PTS) in the observation group was 5.26%, which was significantly higher than that in the control group (26.32%) (P<0.05).There was no significant difference of the incidence of hemorrhagic complication be-tween observation group and the control group (P>0.05). Conclusion Urokinase thrombolysis combined with balloon angioplasty for the treatment of LEDVT has achieved the accurate efficacy and good safety, which can significantly re-duce the incidence of PTS.