下肢深静脉血栓形成静脉滤器植入联合置管溶栓治疗的临床研究

目的探讨下腔静脉滤器植入联合导管溶栓治疗下肢深静脉血栓形成（DVT）的临床疗效。方法选择2008年10月-2010年8月在我院住院治疗的下肢深静脉血栓形成（髂股静脉血栓形成）病人64例,其中治疗组32例,对照组32例,治疗组病人在数字减影血管造影技术（DSA）下植入下腔静脉滤器后,溶栓导管直接插入血栓内,持续注入尿激酶溶栓;对照组采用周身抗凝溶栓治疗。结果 （1）治愈率：对照组治愈率是（32.0%）,治疗组治愈率是（87.5%）,明显高于对照组（P〈0.01）。（2）治疗前后大小腿对应部位平均周径差：治疗前治疗组对应部位平均周径差较对照组差异无显著性（P〉0.05）;治疗后治疗组对应部位平均周径差较对照组明显减小,差异具有显著统计学意义（P〈0.01）。（3）症状性肺动脉栓塞发生率：对照组是15.6%,治疗组0,较对照组减小。（4）平均住院时间：对照组平均住院时间（12±4.5）d,治疗组平均住院时间（9±3.2）d,较对照组缩短,差异具有统计学意义（P〈0.05）。（5）治疗组深静脉通畅率为（87.5%）,对照组深静脉通畅率为（32.0%）,差异具有显著统计学意义（P〈0.01）。结论 （1）下腔静脉滤器植入联合置管溶栓技术可有效治疗下肢深静脉血栓形成;（2）下腔静脉滤器可有效预防肺动脉栓塞的发生。

Analysis the efficacy of implantation vena cava filtercombined thecathetering thrombolysis therapy in the treatment of deep venous thrombosis of lower-limb

Objective To evaluate the clinical efficacy of implantation vena cava filterthecombined the cathetering thrombolysis therapy in the treatment of deep venous thrombosis of lower-limb.Methods Total 64patients with deep venous thrombosis were treated in my hospital from October 2008 to Auguest 2010.The patients were divided into experiment group（32 cases）and control group（32 cases）.The experiment group of with DVT underwent in the DSA were implanted vena cava filters,intraluminal cathter-directed thrombolysis with urokinase inpact and con-tinuous infusion.The control group were treated with venousthrombolysis therapy.Results（1）Cure rate of the control group reached 32.0%,Cure rate of the experiment group reached 87.5%,Clinlcal cure rate of two groups had significant differences（P0.01）.（2）Average thigh and limb circumference two groups had significant difference after therapy.（3）Occurrence rate of PE of two groups had significant difference.（4）Average hospital stay of two groups had significant difference（P0.05）.（5）The patency rate of two groups had significant difference（P0.01）.Conclusion（1）The thrombolytic therapy by implantation vena cava filter combined thecathetering is a safe and effective theraputic means in the treatment of deep venous thrombosis.（2）Thevena cava filter can effectively prevent PE.