体外超声助溶下肢深静脉血栓的近期疗效及其对凝血和纤溶的影响

目的观察体外治疗性超声联合尿激酶溶栓治疗下肢深静脉血栓的近期临床疗效和对患者凝血纤溶的影响。方法将入选的92例下肢深静脉血栓形成患者随机分为两组:治疗组46例,给予体外超声治疗加药物治疗;对照组46例只给予药物治疗。两组于治疗前及治疗后5d分别测定病人凝血和纤溶指标tpA、PAI-1、D-D及FDP。两组于治疗后14d进行超声检查及临床疗效评定。结果超声治疗组近期疗效与对照组比较有非常显著的差异(u=3.24,P0.01),两组血管再通率比较有显著的统计学意义(x2=8.94,P0.01)。治疗组血管再通时间明显缩短(4.5±2.6dvs7.7±3.5d,t=3.63,P0.01)。两组治疗后D-D及FDP比较也有显著性差异(P0.01),两组治疗后组内及组间比较tPA及PAI变化无统计学意义(P0.05)。结论体外超声治疗能加强尿激酶的溶栓效果,促使其纤溶作用,对凝血无影响,可作为DVT的辅助治疗手段。

Clinical short-term effects of exttrnal therapeutic ultrasound treatment on deep vein thrombosis and blood coagulation and fibrinolytic system

Objective] To observe the clinical short-term effect of external therapeutic ultrasound（ETUS）in the treatment for deep vein thrombosis（DVT）,on the blood coagulation and fibrinolysis.Methods] Ninety-two patients errolled with DVT were randomly divided into two groups：The treatment group（46 cases）were treated with ETUS、urokinase and other antithrombotic medicines,while control group（46 cases）were only administrated with urokinase antithrombotic medicines.All the patients of two groups were tested for the indexex of coagulation and fibrinolysis,after admitted and treated 5 days.After 14 days of treatment,to evaluate the clinical efficacy of two groups patients with ultrasound and other way.Results] The short-term effective rate of treatment group was significantly higher than that of control group（u=3.24,P0.01）.The reperfusion rate of two groups was of significance（x2=8.94,P0.01）.The reperfusion time of treatment group was shorter than that of control group（t=3.63,P0.01）.There were obuiously statistic differences in the changes of D-D and FDP of each group or between two groups（P0.01）,but there were no differences in the changes of tpA and PAI-1 of any group,before and after treated 14days（P0.05）.Conclusions] External therapeutic ultrasound can strengthen the effect of urokinase by intensifying fibriolysis,may not aftect the blood coagulation,it can be used as a way for tratment of DVT.