中国实用外科杂志

中国实用外科杂志 ›› 2010, Vol. 30 ›› Issue (12): 1035-1037.

• 论著 • 上一篇    下一篇

急性下肢深静脉血栓形成导管直接溶栓疗效分析

黄晓钟，梁    卫，薛冠华，叶    猛，张纪蔚   

  1. 上海交通大学医学院附属仁济医院血管外科，上海200001
  • 出版日期:2010-12-01 发布日期:2010-11-25

  • Online:2010-12-01 Published:2010-11-25

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摘要：

目的    评价导管直接溶栓治疗急性下肢深静脉血栓形成的临床疗效。方法    2004年8月至2009年10月，上海交通大学医学院附属仁济医院血管外科对217例急性下肢深静脉血栓形成病人，于数字减影血管造影（DSA）下溶栓导管直接插入静脉血栓，微泵持续灌注尿激酶（261.26±95.35）万单位溶栓。以静脉通畅评分和静脉通畅率评价疗效，治疗半年以上随访。结果    194例病人治疗后静脉造影复查显示，静脉通畅评分显著改善（P<0.01），静脉通畅率（62.24±15.47）%。治疗过程中未出现严重并发症。153例病人取得大于半年随访（随访率70.51%），随访时间6~28（13.75±7.63）个月。静脉造影显示，静脉通畅评分显著改善（P<0.01），静脉通畅率为（68.37±17.54）%。126例深静脉瓣膜得以保存，深静脉瓣膜保存率达82.35%。结论    导管直接溶栓治疗急性下肢深静脉血栓形成，是一种疗效良好而且安全的治疗方法。

关键词: 深静脉血栓形成, 导管直接溶栓, 尿激酶

Abstract:

Catheter-directed thrombolysis for acute lower limb deep venous thrombosis        HUANG Xiao-zhong, LIANG Wei，XUE Guan-hua, et al.  Department of Vascular Surgery, Renji Hospital, Affiliated Shanghai Jiaotong University School of Medical，Shanghai200001，China
Corresponding author： ZANG Ji-wei，E-mail：zhangjiwei001@sina.com  
Abstract    Objective    To evaluate the efficacy of catheter-directed thrombolysis in treatment of acute lower limb deep venous thrombosis(DVT). Method    217 patients with lower limb acute DVT underwent treatment by cathter-directed thrombolysis with urokinase (261.26±95.35)×104IU  continues infusion immediately. The venous patency score and the rate of patency were measured before and after lysis, improvement were observed by venograms. some patients were followed. Results     After lysis, the venous patency score was significant difference (P<0.01). The mean rate of venous patency improvent was （62.24±15.47）%. 153 patients were followed 6~28 monthes, average （13.75±7.63 ）monthes. The mean score of venous patency was also significant difference (P<0.01), the mean rate of venous patency improve to （68.37±17.54）%. The valve function preserved in 126 patients(82.35%). Conclusion    This initial experience suggest that catheter -directed thrombolysis with urokinase for treatment of acute lower limb DVT is safe and effective.

Key words: deep venous thrombosis, catheter thrombolysis, urokinase