急性大面积肺栓塞合并下肢深静脉血栓介入治疗的临床疗效评价

发布时间：2019-03-14 12:03

【摘要】：目的评价介入治疗急性大面积肺栓塞合并下肢深静脉血栓的临床疗效。方法选取本院收治的急性大面积肺栓塞合并下肢深静脉血栓患者30例。依就诊先后顺序随机分为两组。14例在下腔静脉滤器植入后采取导管祛栓联合管溶栓的患者为祛栓组,16例在下腔静脉滤器植入后采取全身静脉溶栓的患者为对照组,观察临床症状、体征、血流动力学改变、血管开通以及并发症情况。结果所有患者临床症状均明显缓解。术后1天祛栓组氧饱和度、动脉血氧分压和休克指数与对照组比较改善明显(P0.01)。术后7天祛栓组健、患肢周径差,静脉通畅度评分和Miller评分与对照组比较显著降低(P0.01)。祛栓组的显效率明显高于对照组(P0.05),无严重手术并发症发生。结论介入治疗急性大面积肺栓塞合并下肢深静脉血栓是一种安全有效的方法。
[Abstract]:Objective to evaluate the clinical efficacy of interventional therapy for acute large area pulmonary embolism complicated with deep venous thrombosis of lower limbs. Methods A total of 30 patients with acute large area pulmonary embolism complicated with deep venous thrombosis of lower extremities were selected. Fourteen patients were treated with catheter and thrombolysis after the implantation of inferior vena cava filter, and 16 patients received systemic thrombolysis after the implantation of inferior vena cava filter, and 16 patients received systemic venous thrombolysis after the implantation of inferior vena cava filter, and the other 16 patients who received systemic thrombolysis after the implantation of inferior vena cava filter were divided into two groups at random. The clinical symptoms, signs, hemodynamic changes, vascular recanalization and complications were observed. Results the clinical symptoms of all patients were relieved obviously. One day after operation, oxygen saturation, arterial oxygen partial pressure and shock index were significantly improved in the suppository group compared with those in the control group (P0.01). On the 7th day after operation, the peripheral diameter difference, venous patency score and Miller score of the dispel suppository group were significantly lower than those of the control group (P0.01). The effective rate in the suppository group was significantly higher than that in the control group (P0.05), and there were no serious operative complications. Conclusion Interventional treatment of acute large area pulmonary embolism combined with deep venous thrombosis of lower limbs is a safe and effective method.
【作者单位】：承德医学院附属医院血管外科;承德医学院附属医院检验科;
【基金】：河北省科技支撑计划项目(20122162)
【分类号】：R563.5;R654.4

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