急性下肢深静脉血栓形成腔内治疗的中远期疗效观察

目的：评估血管腔内治疗急性下肢深静脉血栓形成（DVT）的中远期疗效。 方法：选取2007年10月至2017年5月东莞市人民医院收治的180例下肢DVT患者，其中120例接受血管腔内治疗联合导管接触性溶栓治疗（介入组）；60例在足量抗凝治疗基础上，经患肢足背静脉局部溶栓（对照组）；所有患者出院后抗凝治疗2年；介入组26例患者停止抗凝后血栓复发，再次接受血管腔内治疗，其后终身抗凝治疗；比较两组的治疗效果、髂静脉通畅率及血栓后综合征（PTS）发生率。 结果：介入组的有效率明显优于对照组（100% vs. 86.7%），差异有统计学意义（Z=113.679，P<0.05）；介入组治疗1、2、5、10年后，患侧髂静脉血管通畅率分别为89.2%、95%、84.6%、100%，远高于对照组的8.3%、5%、0%、0%；介入组PTS发生率（13.3%）明显低于单纯抗凝治疗组（46.7%），差异有统计学意义。 结论：血管腔内治疗能有效提高DVT患者的治疗效果，降低PTS的发生率，血管腔内治疗急性DVT安全、有效。

Mid-term and long-term therapeutic effect of endovascular therapy for acute deep vein thrombosis

Objective:To evaluate the mid-term and long-term efficacy of endovascular treatment for acute deep vein thrombosis (DVT) of lower extremities. Methods:The clinical data of 180 patients with acute lower extremity DVT in our department from October 2007 to May 2017 were selected. The clinical outcome of interventional therapy group and control group was analyzed. 120 patients with lower extremity DVT underwent endovascular treatment (intervention group) , combined with catheter-directed thrombolysis. After stopping anticoagulation, 26 patients in interventional therapy group with thrombosis recurrence underwent endovascular treatment again, and then lifetime anticoagulant therapy. 60 patients in control group with adequate anticoagulant therapy, underwent local thrombolysis through the dorsal vein of the involved limb. All the 180 patients underwent anticoagulation treatment for 24 months. Results:The effective rate of the intervention group was significantly better than that of the control group (100% vs. 86.7%) , with significant difference (Z=113.679, P<0.05) . The patency rates of the iliac veins in intervention group after 1, 2, 5, and 10 years was significantly higher than that in control group (89.2%, 95%, 84.6%, 100% vs. 8.3%, 5%, 0%, 0%) respectively. The rate of post-thrombotic syndrome (PTS) in intervention group (13.3%) was significantly lower than that in control group (46.7%) , the difference was statistically significant. Conclusions:Endovascular treatment can effectively improve the therapeutic effect of patients with DVT and reduce the incidence of PTS in patients with acute lower extremity DVT. Therefore, endovascular treatment for deep venous thrombosis of the lower extremity is safe and effective.