下肢深静脉血栓的综合介入治疗

目的研究经颈静脉滤器植入联合足背静脉加压溶栓治疗下肢静脉血栓形成的有效性与安全性。方法临床入选82例下肢静脉血栓形成患者，按照随机数字方法分成2组，每组41例，其中研究组在放射介入引导下行颈静脉滤器植入联合足背静脉加压溶栓，对照组单独采用足背静脉加压溶栓治疗。治疗后，比较分析两组患者的相关临床资料。结果研究组的溶栓时间和应用尿激酶总量较对照组显著减少，溶栓前后大腿和小腿周径缩小长度较对照组显著增大（19〈0．05）；两组患者的住院时间没有统计学差异（P〉0．05）；对照组患者的总有效率为70．73％，研究组患者的总有效率为87．81％，两组相比较具有统计学差异（P〈0．05）；对照组患者的治疗并发症发生率为36．59％，研究组患者的治疗并发症发生率为34．15％，两组相比较没有统计学差异（P〉0．05）。结论经颈静脉滤器植入联合足背静脉加压溶栓治疗下肢静脉血栓形成具有较好的有效性与安全性。

Study on lower limb deep venous thrombosis treated by comprehensive intervention

Objective To investigate the efficacy and safety of trans-jugular catheter-directed thrombolysis combined with trans-dorsalis pedis vein thrombolysis in the treatment of deep venous thrombosis of the lower limbs. Methods Totally 82 patients with deep venous thrombosis of the lower limbs were reviewed and randomly divided into control group and study group （n=41 ）. The patients in control group were given trans-dorsalis pedis vein thrombolysis while those in study group were given trans-jugular catheter-directed thrombolysis combined with trans-dorsalis pedis vein thrombolysis. The clinical data of the two groups were compared. Results The thrombolytic time and total dose of urokinase in study group were significantly reduced compared with those in control group ,while the thigh circumference and calf circumference were obviously increased compared with those in control group （ P 〈 0.05 ）. There was no significant difference in hospitalization time between the two groups （ P 〉 0. 05 ）. Meanwhile, there were significant differences in total effective rate between the two groups, 70.73% vs. 87.81% （P 〈 0.05 ）. However, there was no significant difference in the complication incidence between the two groups, 36.59% vs. 34.15% （P 〉 0.05 ）. Conclusion This study indicates that trans-jugular catheter-direeted thrombolysis combined with transdorsalis pedis vein thrombolysis is an effective and safe therapeutic technique for deep venous thrombosis of the lower limbs.