CatheterDirected Thrombolysis for Patients with Acute Deep Vein Thrombosis of Lower Limb (Report of 28 Cases)_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

徐贵云 , 蒋厚文 , 郝立俊 , 陈闯

Corresponding author：

Keywords：

深静脉血栓形成; 抗凝; 导管溶栓; 腘静脉; 下腔静脉滤器

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探讨经腘静脉置溶栓导管灌注溶栓治疗急性下肢深静脉血栓形成（DVT）的临床应用价值。方法对28例急性DVT患者（其中2例合并肺动脉栓塞）在超声引导下经患肢腘静脉穿刺置入溶栓导管至髂、股静脉血栓中进行溶栓治疗，并对溶栓效果进行分析。结果全组患者溶栓后症状明显改善，下肢肿胀消退，肺部症状缓解。溶栓后患、健侧大腿周径差〔(1.72±1.23) cm〕明显小于溶栓前〔(5.47±1.29) cm〕,差异有统计学意义(t=12.14，P lt;0.01)，患肢大腿消肿率为91.58%; 溶栓后患、健侧小腿周径差〔(1.55±0.77) cm〕也明显小于溶栓前〔(5.04±1.32) cm〕，差异有统计学意义（t=13.81，P lt;0.01)，患肢小腿消肿率为84.92%。溶栓后静脉通畅评分〔(4.34±3.55)分〕明显低于溶栓前〔(15.23±4.64) 分〕，差异有统计学意义(t=6.42，P lt;0.01 )，溶栓后静脉平均通畅率为87.43%。 2例合并肺动脉栓塞患者中，1例栓子完全溶解，1例大部分溶解。所有患者均无严重并发症。 25例患者获随访，随访1～12个月（平均7.16个月），无一例出现血栓再发。结论经腘静脉置管溶栓治疗急性DVT是一种安全、有效的治疗方法。

Citation： 徐贵云,蒋厚文,郝立俊,陈闯. CatheterDirected Thrombolysis for Patients with Acute Deep Vein Thrombosis of Lower Limb (Report of 28 Cases). CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(2): 204-206. doi: Copy

1.	刘咸罗, 钱小星, 汤永胜, 等. 急性下肢深静脉血栓形成的实验与临床研究 [J]. 中国现代普通外科进展, 2009, 12(4): 317320.
2.	Porter JM, Moneta GL. Reporting standards in venous disease: an update. International Consensus Committee on Chronic Venous Disease [J]. J Vasc Surg, 1995, 21(4): 635645.
3.	Hamilton W. Malignancy and deep vein thrombosis [J]. Br J Gen Parct, 2006, 56(532): 886.
4.	Segal JB, Streiff MB, Hofmann LV, et al. Management of venous thromboembolism: a systematic review for a practice guideline [J]. Ann Intern Med, 2007, 146(3): 211222.
5.	张柏根. 下肢深静脉血栓形成治疗和预后的几个问题 [J]. 中华普通外科杂志, 2006, 21(2): 8183.
6.	Baldwin ZK, Comerota AJ, Schwartz LB. Catheterdirected thrombolysis for deep venous thrombosis [J]. Vasc Endovascular Surg, 2004, 38(1): 19.
7.	郑江华, 武国, 朱彦彬，等. 腔静脉滤器置入联合导管直接溶栓治疗下肢深静脉血栓形成临床分析 [J]. 中国普外基础与临床杂志, 2010, 17(7): 679682.
8.	Mewissen MW, Seabrook GR, Meissner MH, et al. Catheterdirected thrombolysis for lower extremity deep venous thrombosis: report of a national multicenter registry [J]. Radiology, 1999, 211(1): 3949.
9.	张精勇, 金星, 吴学君, 等. 滤器保护下置管溶栓治疗下肢深静脉血栓形成临床总结 [J]. 中国实用外科杂志, 2006, 26(10): 774776.
10.	Greenfield LJ, Proctor MC. Recurrent thromboembolism in patients with vena cava filters [J]. J Vasc Surg, 2001, 33(3): 510514.
11.	Harenberg J. Fixeddose versus adjusteddose low molecular weight heparin for the initial treatment of patients with deep venous thrombosis [J]. Curr Opin Pulm Med, 2002, 8(5): 383388.
12.	Alesh I, Kayali F, Stein PD. Catheterdirected thrombolysis (intrathrombus injection) in treatment of deep venous thrombosis: a systematic review [J]. Catheter Cardiovasc Interv, 2007, 70(1): 143148.
13.	李国剑, 杨国凯, 何晓明, 等. 下腔静脉滤器在治疗下肢深静脉血栓中的应用 [J]. 中国普外基础与临床杂志, 2009, 16(11): 922924.

1. 刘咸罗, 钱小星, 汤永胜, 等. 急性下肢深静脉血栓形成的实验与临床研究 [J]. 中国现代普通外科进展, 2009, 12(4): 317320.
2. Porter JM, Moneta GL. Reporting standards in venous disease: an update. International Consensus Committee on Chronic Venous Disease [J]. J Vasc Surg, 1995, 21(4): 635645.
3. Hamilton W. Malignancy and deep vein thrombosis [J]. Br J Gen Parct, 2006, 56(532): 886.
4. Segal JB, Streiff MB, Hofmann LV, et al. Management of venous thromboembolism: a systematic review for a practice guideline [J]. Ann Intern Med, 2007, 146(3): 211222.
5. 张柏根. 下肢深静脉血栓形成治疗和预后的几个问题 [J]. 中华普通外科杂志, 2006, 21(2): 8183.
6. Baldwin ZK, Comerota AJ, Schwartz LB. Catheterdirected thrombolysis for deep venous thrombosis [J]. Vasc Endovascular Surg, 2004, 38(1): 19.
7. 郑江华, 武国, 朱彦彬，等. 腔静脉滤器置入联合导管直接溶栓治疗下肢深静脉血栓形成临床分析 [J]. 中国普外基础与临床杂志, 2010, 17(7): 679682.
8. Mewissen MW, Seabrook GR, Meissner MH, et al. Catheterdirected thrombolysis for lower extremity deep venous thrombosis: report of a national multicenter registry [J]. Radiology, 1999, 211(1): 3949.
9. 张精勇, 金星, 吴学君, 等. 滤器保护下置管溶栓治疗下肢深静脉血栓形成临床总结 [J]. 中国实用外科杂志, 2006, 26(10): 774776.
10. Greenfield LJ, Proctor MC. Recurrent thromboembolism in patients with vena cava filters [J]. J Vasc Surg, 2001, 33(3): 510514.
11. Harenberg J. Fixeddose versus adjusteddose low molecular weight heparin for the initial treatment of patients with deep venous thrombosis [J]. Curr Opin Pulm Med, 2002, 8(5): 383388.
12. Alesh I, Kayali F, Stein PD. Catheterdirected thrombolysis (intrathrombus injection) in treatment of deep venous thrombosis: a systematic review [J]. Catheter Cardiovasc Interv, 2007, 70(1): 143148.
13. 李国剑, 杨国凯, 何晓明, 等. 下腔静脉滤器在治疗下肢深静脉血栓中的应用 [J]. 中国普外基础与临床杂志, 2009, 16(11): 922924.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

CatheterDirected Thrombolysis for Patients with Acute Deep Vein Thrombosis of Lower Limb (Report of 28 Cases)

Abstract Full text Figures/Tables Video References Cited by

Format

Content