置管溶栓、血栓切除术与系统抗凝治疗急性髂股段静脉血栓形成的疗效荟萃分析

发布时间：2018-05-15 01:05

本文选题：髂股静脉 + 抗凝　；参考：《安徽医科大学》2015年硕士论文

【摘要】：目的应用Meta分析研究单纯系统抗凝(systemic anticoagulation, SA)、置管溶栓(catheter-directed thrombolysis, CDT)与血栓切除(surgical thrombectomy, ST)治疗急性髂股段血栓形成(acute iliofemoral deep vein thrombosis, AIFDVT)的疗效。方法选取1984年1月至2014年1月近30年间发表的10篇关于SA. ST. CDT临床效果的随机对照研究,应用Meta分析评价早期血管再通率、深静脉血栓后遗症(post-thrombotic syndrome, PTS)发生率、血管返流(venous reflux, VR)率、管腔堵塞(venous obstruction, VO)率等相关指标。共有10篇随机对照研究纳入此分析,包括626例患者。早期血管再通率：CDT组高于SA组,差异有统计学意义(OR=4.61,95%CI 1.93～10.98,p=0.0006);ST组与SA组比较差异无统计学意义(OR=2.54,95%CI 0.49～13.24, p=0.27);术后PTS发生率：CDT组低于SA组(OR=0.18,95%CI 0.07～0.43, p=0.0002),ST组低于SA组(OR=0.50,95%CI 0.28～0.87, p=0.01),差异均有统计学意义；术后VR发生率：CDT组与SA组比较(OR=0.54,95%CI 0.29～1.01,p=0.05)、ST组与SA组比较(OR=0.54,95%CI 0.27～1.08,p=0.08)差异均无统计学意义；术后VO发生率：CDT组低于SA组,差异有统计学意义(OR=0.19,95%CI 0.11～0.34,p0.01),ST组与SA组比较差异无统计学意义(OR=1.53,95%CI 0.72～3.26,p0.27)。结论CDT治疗AIFDVT的早期疗效(7天)明显优于传统的系统抗凝。关于远期疗效(6月),血栓切除术、置管溶栓较传统的系统抗凝均能有效降低PTS发生率,且置管溶栓还能降低血管内栓塞的发生率。
[Abstract]:Objective to study the efficacy of systemic anticoagulation, catheter-directed thrombolysis (CDTs) and thrombectomy in the treatment of acute iliofemoral thromboembolism (iliofemoral deep vein thrombosis, AIFDVT) by Meta analysis. Methods Ten articles about SAA from January 1984 to January 2014 were selected. ST. In a randomized controlled study of the clinical effects of CDT, Meta analysis was used to evaluate the early vascular recanalization rate, post-thrombotic syndromes (PTSs), venous reflux rate, venous obstruction rate and so on. A total of 10 randomized controlled studies were included in this analysis, including 626 patients. The recanalization rate of early blood vessels in the group of: 1: CDT was higher than that in the group of SA, and the difference was statistically significant (P < 0.01). There was no significant difference between the St group and the SA group in CI 0.490.24, p0.27.The incidence of postoperative PTS in the control group was lower than that in the SA group, and the incidence of postoperative PTS was lower than that in the control group (P 0.1895 CI 0.07 卤0.43), and the difference was statistically significant in the control group (P 0.0002P = 0.5095 CI 0.280.87, P 0.01). There was no significant difference in the incidence of VR between the two groups, and there was no significant difference in the incidence of VR between the two groups, but the incidence of VO in the group of VO was lower than that in the group of SA, and there was no significant difference between the St group and the SA group (CI: 0.1995 CI 0.110.34) and the group of SA. There was no significant difference between the St group and the SA group in terms of CI 0.7395CI 0.723.26p0.270.27 (P = 0.27), and there was no significant difference between the St group and the SA group (P > 0.05), but there was no significant difference between the two groups in the incidence rate of VR (P < 0.05), the incidence of VO was lower than that in the group of SA (P = 0.1995), and the difference was not statistically significant between the St group and the SA group. Conclusion the early therapeutic effect of CDT on AIFDVT is better than that of traditional systemic anticoagulant. Long-term results (6 months thrombectomy and thrombolytic catheterization compared with the traditional system of anticoagulation can effectively reduce the incidence of PTS and catheter thrombolysis can also reduce the incidence of intravascular embolism.
【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】：R654.4

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