导管接触性溶栓治疗急性期髂股静脉血栓形成的临床疗效分析

摘要

Objective To investigate the feasibility and efficacy of catheter-directed thrombolysis (CDT ) approach in treatment for acute iliofemoral vein thrombosis (IFVT ) of lower limbs .Methods A retrospective analysis of clinical data was made in 86 patients with acute IFVT from 2008 to 2012 who underwent CDT and TPVT in our hospital .Fifty patients underwent CDT and 36 patients TPVT .Before and after treatment ,the circumference of both the diseased leg and the un-involved leg ,venous patency rates and the incidence of Post-thrombotic Syndrome (PTS) were measured and calculated . Results The circumference difference of leg or upper leg before and after treatment of CDT group was significantly greater than that in the TPVT group ( P <0 .05) .The rate of venous patency was 65 .0% in TDT group ,and 49 .0% in TPVT group ,respectively .The differences of venous patency rate between these two groups were statistically significant ( P <0.05) .There was a significant difference of Villalta score and incidence of PTS between CDT and TPVT groups ( P <0.05) .CDT can reduce dose of urokinase ,shorten the course of disease .There was no significant difference of complica-tion between two groups .Conclusion Catheter-directed thrombolysis for acute iliofemoral vein thrombosis is a safe and ef-fective treatment .%目的：探讨导管接触性溶栓治疗急性期髂股静脉血栓形成的临床疗效。方法回顾性分析我院2008年～2012年期间86例急性期髂股静脉血栓形成患者的临床资料，以下肢周径差变化、静脉通畅度评分、静脉通畅率及深静脉血栓后综合征（PTS）发生率评估治疗效果；以出血并发症、肺栓塞等发生率评估其安全性。结果导管直接溶栓（CDT ）组治疗前、后大腿和小腿的周径差显著高于单纯静脉溶栓治疗（TPVT ）组（ P ＜0．05）。治疗前后CDT组静脉通畅度率显著高于TPVT组（ P ＜0．05）；CDT组Villalta评分、PTS及并发症发生率显著低于 TPVT 组（ P ＞0．05）。结论导管接触性溶栓治疗急性期髂股静脉血栓形成是一种安全有效的治疗方法。