肝素在血栓性病变介入溶栓治疗中的作用

目的：探讨肝素在血栓性病变的介入性溶栓抗凝治疗中的作用。方法：急性脑血栓形成22例，四肢动脉血栓18例，髂股静脉血栓200例，下腔静脉血栓20例，分别给以肝素或小分子肝素行全身抗凝。经导管或局部给以溶栓、消融和下腔静脉过滤器放置等治疗，术中和术后也全身使用肝素抗凝治疗。结果：动脉血栓在肝素抗凝下，经导管溶栓疗效肯定，术后必须以肝素抗凝才能保持管腔通畅；髂股静脉血栓形成后完全再通率低于动脉系统。肝素与溶栓药物联合应用疗效高于单纯使用溶栓药物。结论：血栓性病变的治疗应首先使用肝素抗凝，其次溶栓。溶栓必须和肝素抗凝联合，这是对血栓性疾病进行介入治疗的原则之一。

The role of heparin in the interventional therapy for thrombotic diseases

Objective To evaluate the role of heparin in treating thrombotic diseases by interventional radiology.Methods In order to perform general anticoagulation, heparin or small molecule heparin were used for patients with acute brain thrombosis in 22 cases, limb artery thrombosis in 18 cases, ilic and formal vein thrombosis in 200 cases, inferior vena cava thrombosis in 20 cases. All patients were treated by thrombolysis with UK, or placing filter in inferior vena cava simultaneously with heparin. Results Under general anticoagulation, the effects of thrombosis dissolution for artery were positive. After thrombolysis, heparin must be used to keep the vascular patency. The recanalization of iliac and formal veins was lower than that of artery. The effect of applying heparin combined with thrombolysis was better than that of thrombolysis alone. Conclusions During the course of therapy of thromobotic diseases application of heparin should be the first and their follow by thrombolysis that is the principle for interventional therapy.