溶栓治疗预防血栓形成后综合征的临床研究
发布时间：2018-08-26 10:46
【摘要】：研究背景下肢深静脉血栓形成(DVT)是常见的一种血管外科疾病,具有较高的发病率和死亡率,仅少数患者可获得痊愈,大多数血栓患者将发展为血栓形成后综合征(PTS)。血栓形成后综合征是下肢深静脉血栓后期严重并发症之一,有学者报道大约20%-50%的患者在两年内发展为PTS,其中约5%-10%的患者会发展为严重的PTS,即静脉性溃疡,严重影响患者生活质量,给患者带来很大的不便和痛苦,积极治疗及预防是治疗血栓后综合征的关键。 目的本研究通过研究血栓形成后的Villalta评分,分析研究溶栓治疗对下肢深静脉血栓形成后综合征的预防作用。 方法根据随机对照原则,从我院2008年1月至2010年7月的住院患者。年龄在18-75岁的初次DVT患者,症状发作在21天内纳入研究。分别接受单独的常规治疗(A组)和附加溶栓组(B组)。A组给予抗凝、活血化瘀等治疗,B组在A组基础上给予溶栓治疗,通过24个月内Villalta评分评估的PTS发生频率及程度。本组70例下肢深静脉血栓中,A组28人,B组42人,B组42例患者均放置下腔静脉滤器。结果经积极治疗后,全组70例患者,下肢肿胀得到改善,两组治疗前后健测与患侧下肢周径差(包括大腿中部及小腿中部)均有显著性差异(P0.05)。B组与A组比较,效果更明显,有显著性差异(P0.05)。治疗前两组静脉通畅度评分分别为：9.08±1.38分,9.23±1.33分,差异无统计学差异(P0.05)；治疗后两组静脉通畅度评分分别为：5.17±1.24分,3.68±0.98分,有统计学差异(P0.05)；两组比较,B组静脉通畅度评分明显低于A两(P0.05)。本组70例患者,24月后共有53例患者完成随访,A组21例,B组32例,根据随访结果,通过Villalta评分,发生血栓形成后综合征：A组：正常13人,轻度4人(5-9)分,中度3人(10～14)分,重度1人.(15或者溃疡)。B组：正常23人,轻度6人,中度3人,重度0人。 结论1、溶栓治疗能降低血栓后综合征的发生,是一种治疗下肢深静脉的方法。 2. Villalta评分能从客观及主观上评价血栓形成后综合征,是一种较好的血栓形成后综合征的评估工具。
[Abstract]:Background Deep venous thrombosis (DVT) is a common vascular surgery disease with high morbidity and mortality. Only a few patients can be cured. Most of the patients will develop into post-thrombotic syndrome (PTS). Post-thrombotic syndrome is one of the serious complications in the late stage of deep venous thrombosis of the lower extremity. Some scholars report that about 20% to 50% of the patients develop PTS, within two years, and about 5- 10% of the patients develop severe PTS, that is, venous ulcer. It seriously affects the quality of life of patients and brings great inconvenience and pain to patients. Active treatment and prevention is the key to the treatment of post-thrombotic syndrome. Objective to study the preventive effect of thrombolytic therapy on deep vein thrombosis syndrome (DVI) in lower extremity by studying the Villalta score after thrombosis. Methods according to the principle of random control, the inpatients in our hospital from January 2008 to July 2010. Initial DVT patients aged 18-75 were enrolled in the study within 21 days of onset of symptoms. Group A was given anticoagulant therapy, and group B received thrombolytic therapy on the basis of group A by activating blood circulation and removing blood stasis. The frequency and degree of PTS were evaluated by Villalta score within 24 months. The inferior vena cava filter was placed in group A (n = 28), group B (n = 42), group B (n = 42) and group B (n = 42). Results after active treatment, the swelling of lower extremity was improved in 70 patients in the whole group. The difference of circumference diameter of healthy and affected lower limbs (including middle thigh and middle leg) was significantly different between the two groups before and after treatment (P0.05). Compared with group A, the effect of group B was more obvious. There was significant difference (P0.05). Before treatment, the venous patency score of the two groups was 9. 08 卤1. 38 and 9. 23 卤1. 33, respectively (P0.05), and after treatment, the venous patency score of the two groups was 5. 17 卤1. 24 and 3. 68 卤0. 98, respectively (P0.05). Venous patency score in group B was significantly lower than that in group A (P 0.05). A total of 53 patients were followed-up 24 months later. According to the follow-up results, 32 cases in group B were followed up. According to the Villalta score, 13 cases were normal, 4 cases were mild (5-9), 3 cases were moderate (1014). Group B: 23 normal, 6 mild, 3 moderate and 0 severe. Conclusion 1.Thrombolytic therapy can reduce the occurrence of post-thrombotic syndrome and is a method of treating deep vein of lower extremity. 2. Villalta score can evaluate postthrombotic syndrome objectively and subjectively, and it is a good tool for evaluating postthrombotic syndrome.
【学位授予单位】：滨州医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R543.6;R816.2
本文编号：2204633
[Abstract]:Background Deep venous thrombosis (DVT) is a common vascular surgery disease with high morbidity and mortality. Only a few patients can be cured. Most of the patients will develop into post-thrombotic syndrome (PTS). Post-thrombotic syndrome is one of the serious complications in the late stage of deep venous thrombosis of the lower extremity. Some scholars report that about 20% to 50% of the patients develop PTS, within two years, and about 5- 10% of the patients develop severe PTS, that is, venous ulcer. It seriously affects the quality of life of patients and brings great inconvenience and pain to patients. Active treatment and prevention is the key to the treatment of post-thrombotic syndrome. Objective to study the preventive effect of thrombolytic therapy on deep vein thrombosis syndrome (DVI) in lower extremity by studying the Villalta score after thrombosis. Methods according to the principle of random control, the inpatients in our hospital from January 2008 to July 2010. Initial DVT patients aged 18-75 were enrolled in the study within 21 days of onset of symptoms. Group A was given anticoagulant therapy, and group B received thrombolytic therapy on the basis of group A by activating blood circulation and removing blood stasis. The frequency and degree of PTS were evaluated by Villalta score within 24 months. The inferior vena cava filter was placed in group A (n = 28), group B (n = 42), group B (n = 42) and group B (n = 42). Results after active treatment, the swelling of lower extremity was improved in 70 patients in the whole group. The difference of circumference diameter of healthy and affected lower limbs (including middle thigh and middle leg) was significantly different between the two groups before and after treatment (P0.05). Compared with group A, the effect of group B was more obvious. There was significant difference (P0.05). Before treatment, the venous patency score of the two groups was 9. 08 卤1. 38 and 9. 23 卤1. 33, respectively (P0.05), and after treatment, the venous patency score of the two groups was 5. 17 卤1. 24 and 3. 68 卤0. 98, respectively (P0.05). Venous patency score in group B was significantly lower than that in group A (P 0.05). A total of 53 patients were followed-up 24 months later. According to the follow-up results, 32 cases in group B were followed up. According to the Villalta score, 13 cases were normal, 4 cases were mild (5-9), 3 cases were moderate (1014). Group B: 23 normal, 6 mild, 3 moderate and 0 severe. Conclusion 1.Thrombolytic therapy can reduce the occurrence of post-thrombotic syndrome and is a method of treating deep vein of lower extremity. 2. Villalta score can evaluate postthrombotic syndrome objectively and subjectively, and it is a good tool for evaluating postthrombotic syndrome.
【学位授予单位】：滨州医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R543.6;R816.2
【参考文献】
相关期刊论文 前1条
1 彭建宏;王琼;秦亚男;;彩色多普勒超声诊断下肢深浅静脉血栓形成中的价值[J];中国超声诊断杂志;2006年07期
，本文编号：2204633
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