Cockett综合征合并急性期血栓的治疗疗效以及对策

发布时间：2018-02-09 19:24

本文关键词： Cockett综合征深静脉血栓腔内治疗　出处：《中国现代医学杂志》2017年19期 　论文类型：期刊论文

【摘要】：目的分析Cockett综合征合并急性下肢深静脉血栓形成(DVT)的不同治疗手段的疗效,探讨滤器植入是否常规,寻找更加合理治疗方法。方法回顾性分析郑州大学第一附属医院2014年8月-2016年4月期间就诊的89例Cockett综合征并发急性下肢DVT患者,按治疗方式分为实验组(A、B组)和对照组(C组)。A组36例均行下腔滤器植入+置管溶栓,其中11例行球扩,16例行球扩+支架;B组22例均行置管溶栓,其中7例行球扩,11例行球扩+支架,C组31例行系统溶栓保守治疗,术后给予抗凝、活血、消肿、穿弹力袜,院外均口服华法林继续抗凝,观察各组治疗疗效及血栓相关事件发生率。结果 87例获得随访,随访时间为3~20个月。A和B组有效率均为100%,C组有效率为80%,均未出现肺栓塞,无疾病相关死亡病例,实验组中A组与B组肺栓塞发生率及治疗疗效差异均无统计学意义(P0.05)。实验组和对照组比较,实验组症状均得到明显缓解,对照组中6例肢体缓解不明显,疗效差异有统计学意义(P0.05);血栓后遗症发生率差异有统计学意义(P0.05),实验组低于对照组。结论对于Cockett综合征合并急性期血栓治疗,不常规植入下腔静脉滤器也是安全有效的;腔内治疗较药物系统溶栓中远期效果好,通畅率高,发生血栓后综合征风险明显降低。
[Abstract]:Objective to analyze the effect of different treatment methods on Cockett syndrome with acute deep venous thrombosis (DVT), and to investigate whether filter implantation is routine. Methods 89 patients with Cockett syndrome complicated with acute lower limb DVT from August 2014 to April 2016 in the first affiliated Hospital of Zhengzhou University were analyzed retrospectively. The patients were divided into two groups according to the treatment methods: group A (n = 36) and group C (n = 36). Thrombolytic therapy was performed in group B (n = 16), and thrombolysis was performed in group B (n = 22). Among them, 7 cases were treated with bulbar expansion, 11 cases were treated with systemic thrombolytic conservative therapy, 31 cases were treated with systemic thrombolytic conservative therapy, after operation, anticoagulant, blood circulation, detumescence, elastic socks were worn, warfarin was taken orally outside the hospital to continue anticoagulant therapy. Results 87 cases were followed up for 3 ~ 20 months. The effective rates of group A and B were 80%, no pulmonary embolism and no disease related death. There was no significant difference in the incidence and curative effect of pulmonary embolism between group A and group B. compared with control group, the symptoms of experimental group and control group were obviously relieved, and 6 cases of control group were not significantly relieved. The difference of curative effect was statistically significant (P 0.05) and the incidence of thrombotic sequelae was significantly lower in the experimental group than in the control group. Conclusion it is also safe and effective for Cockett syndrome with acute thromboembolism to implant the inferior vena cava filter. Endovascular therapy was more effective and patency than drug system thrombolytic therapy, and the risk of post-thrombotic syndrome was significantly reduced.
【作者单位】：郑州大学第一附属医院大血管外科;
【分类号】：R543.6

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