置管溶栓与足背静脉溶栓在治疗DVT时的早期临床疗效对比

发布时间：2018-02-25 15:37

本文关键词： 深静脉血栓形成下腔静脉滤器置管溶栓足背静脉溶栓　出处：《安徽医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:在下腔静脉滤器保护下,使用置管溶栓与足背静脉溶栓这两种不同的溶栓方法治疗下肢深静脉血栓形成(DVT),对比这两种溶栓方法的早期临床疗效。方法:选择我院普外科2012年6月至2014年6月下肢DVT患者,其中符合既往无DVT发生病史、深静脉血栓发生时间在1周内,且因病情需要行溶栓治疗并同意治疗的86例患者作为研究对象。随机分为足背静脉溶栓组(N=36)与导管溶栓组(N=48)。通过静脉通畅率及临床症状改善情况评价其早期疗效。结果:86例患者中,2例患者植入下腔静脉滤器失败故未开始溶栓治疗,84例患者植入成功,48例置入导管溶栓的患者治疗时,43例患者3天时患肢肿胀明显消退,37例患者一周基本恢复正常;2周时患肢静脉通畅率为77.1%,而采用足背静脉溶栓治疗的36例患者,16例患者3天时患肢肿胀明显消退,9例患者一周基本恢复正常;2周时患肢静脉通畅率为25%,静脉通畅率置管溶栓患者组高于足背静脉溶栓组;术前两组患者的周径差对比无统计学意义(P0.05),术后两组患者第3天、1周、2周时患肢与健肢的周径差,较之术前明显降低(P值分别为0.003、0.001、0.002),且置管溶栓组患肢与健肢周径差明显低于经足背静脉溶栓组,两组相比差异有统计学意义(P0.01)。在静脉通畅度方面,置管溶栓组的77%亦远高于足背静脉溶栓组的25%。结论:在下腔静脉滤器保护下,应用足背静脉溶栓治疗DVT可取得一定疗效,但应用置管溶栓能更加迅速的改善下肢静脉回流障碍,静脉通畅率提高明显,较之足背静脉溶栓早期疗效更加显著。
[Abstract]:Objective: under the protection of inferior vena cava filter, Two different thrombolytic methods, catheterization thrombolytic therapy and dorsal foot venous thrombolytic therapy, were used to treat DVT of deep vein thrombosis of lower extremity. The early clinical effects of these two methods were compared. Methods: from June 2012 to June 2014, the patients with DVT of lower extremity in our hospital were selected. There was no history of DVT, and the time of occurrence of deep venous thrombosis was within 1 week. 86 patients who needed thrombolytic therapy and agreed to the treatment were randomly divided into dorsal foot thrombolytic group (n = 36) and catheter thrombolytic group (n = 48). The early curative effect was evaluated by the rate of patency of vein and the improvement of clinical symptoms. Results of 86 cases, 2 cases failed to implant inferior vena cava filter, 84 cases failed to start thrombolytic therapy. 48 cases successfully implanted catheter thrombolytic therapy. 43 cases of patients with thrombolytic therapy were treated with thrombolytic catheter for 3 days. The swelling of the affected limbs subsided obviously. 37 cases suffered from thrombolytic therapy. The patency rate of the affected limb vein was 77.1 at 2 weeks, while 36 patients with thrombolytic therapy of dorsalis pedis vein were treated with thrombolytic therapy for 3 days. The swelling of the affected limb disappeared significantly in 3 days. In 9 patients, the normal limb became normal at 2 weeks after thrombolytic therapy. The vein patency rate was 25%, the venous patency rate in the thrombolytic group was higher than that in the dorsal foot-vein thrombolytic group. There was no significant difference in the circumference difference between the two groups before operation (P 0.05). The difference of the circumference between the affected limb and the healthy limb at the 3rd day and the 2nd week after operation was observed in the two groups. Compared with preoperative, the P value of thrombolytic thrombolytic group was 0.003 / 0.001 / 0.002, respectively, and the difference of circumference diameter between the affected and healthy limbs in the thrombolytic group was significantly lower than that in the thrombolytic group via dorsal foot vein, the difference between the two groups was statistically significant (P 0.01), and the patency of vein was significantly lower in the thrombolytic group than that in the control group. 77% in the thrombolytic group was significantly higher than that in the thrombolytic group in the dorsal foot-vein group. Conclusion: under the protection of inferior vena cava filter, thrombolytic therapy of the dorsal vena pedis vein can obtain certain curative effect, but the thrombolytic therapy can improve the obstruction of venous reflux in the lower extremity more quickly. The patency rate of vein increased significantly, compared with the early effect of thrombolysis on dorsal foot vein.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.3

【参考文献】