Angiojet机械血栓清除术治疗急性下肢深静脉血栓形成对静脉瓣膜功能的影响

目的 探索Angiojet机械血栓清除术治疗急性下肢深静脉血栓形成（LEDVT）能否早期保护下肢深静脉瓣膜功能、降低深静脉血栓形成后综合征（PTS）的发生率和严重程度，评估Angiojet机械血栓清除术对急性LEDVT病人早期的疗效及影响。方法 回顾性分析2020年6月至2021年7月收治在贵州医科大学附属医院血管外科的中央型或混合型急性下肢深静脉血栓形成病人85例。分为观察组40例和对照组45例，对照组只接受抗凝治疗，观察组接受抗凝治疗的同时进行Angiojet机械血栓清除术。收集两组病人的基本资料和治疗情况并在治疗6个月时进行超声随访，观察股静脉有无反流（如有反流则计算出反流指数），进行Villalta评分，分析两组并发症情况。结果 观察组治疗3 d后患肢膝上10 cm的周径差大于对照组，差异有统计学意义[（3.545±0.935）cm比（2.242±0.575）cm,P<0.001];6个月时超声随访，观察组股静脉通畅率高于对照组，差异有统计学意义（95%比77.8%,P=0.023）；其中再通病人观察组瓣膜完好率高于对照组，差异有统计学意义（84.2%比54.3%,P=0...

Effect of angiojet mechanical thrombus removal on venous valve function in patients with acute lower extremity deep vein thrombosis

Objective To explore whether Angiojet mechanical thrombectomy in the treatment of acute lower extremity deep veinthrombosis (LEDVT) can protect the venous valve function of patients with LEDVT in the early stage and reduce the incidence and severity of post-deep vein thrombotic syndrome (PTS), and to evaluate the early efficacy and impact of Angiojet mechanical thrombectomyon patients with acute LEDVT.Methods The patients of 85 cases with central or mixed acute LEDVT treated in the Department ofvascular surgery of the Affiliated Hospital of Guizhou Medical University from June 2020 to July 2021 were analyzed retrospectively.The patients were assigned into observation group (n=40) and control group (n=45). The control group only received anticoagulant therapy, which the observation group underwent anticoagulant therapy and Angiojet mechanical thrombectomy. The basic data and treatmentof the patients were collected, and the patients were followed up by ultrasound at 6 months of treatment to understand whether there wasfemoral vein reflux (if there was reflux, the reflux index was calculated) and calculate Villalta score. At the same time, the complications of the two groups were analyzed.Results The circumferential diameter difference of 10 cm on the knee of the affected limb in ob servation group after 3 days of treatment was greaterr than that in control group, and the difference was statistically significant [(3.545±0.935) cm vs. (2.242±0.575) cm, P<0.001]. At 6 months follow-up by ultrasound, the patency rate of femoral vein in observation groupwas higher than that in control group, the difference was statistically significant (95% vs. 77.8%, P=0.023); Among them, the patientswith femoral vein valve regurgitation in observation group was less than that in control group, the difference was statistically significant(84.2% vs. 54.3%, P=0.005). The reflux index of patients with regurgitation in observation group was lower than that in control group,the difference was statistically significant (0.86±0.34 vs. 1.82±0.52, P<0.001); Villalta score, PTS incidence rate and PTS severity inobservation group were lower than those in control group, the difference was statistically significant (P<0.05). Relative risk analysis was performed with mechanical thrombectomy as exposure factor, RR=0.15, 95%CI: (0.04, 0.55). In terms of complications, hemoglobinuriain the observation group was higher than that in the control group, the difference was statistically significant (P<0.001), and there was no significant difference in bleeding, PE and acute renal injury between the two groups (P>0.05).Conclusions Angiojet mechanicalthrombectomy is safe and effective in the treatment of acute LEDVT. It has a protective effect on deep venous valve function. It can better alleviate the immediate clinical symptoms and reduce the incidence and severity of PTS. The lower incidence and severity of PTSmay benefit from the maintenance of venous valve function, and finally enable DVT patients to obtain early and medium-term benefits from the treatment of Angiojet mechanical thrombus.