下肢深静脉血栓形成外科治疗分析

目的: 总结下肢深静脉血栓形成(deep vein thrombosis,DVT)手术治疗32例(36条肢体)经验。方法: 32例(36条肢体)下肢DVT患者进行顺行深静脉造影及彩超确诊。运用Fogarty取栓管逆行取栓,29例重建主干血管,其中Palma手术3例,左右股静脉人工血管搭桥23例,股总→髂总静脉搭桥2例,股总→下腔静脉搭桥1例。术中术后用肝素及尿激酶抗凝溶栓治疗。结果: 术后下肢症状完全消失17例(18条肢体),活动后小腿水肿休息后消失9例,3例血栓复发。10天内急性期25条肢体,治愈16例(64.0%),超过10天慢性期治愈4例(36.4%),1例发生肺栓塞。结论: 急性期下肢DVT手术取栓合并主干血管重建效果较好,同时配合术后综合治疗预防血栓复发。

Surgical treatment of deep vein thrombosis of lower extremity

Objective:To summarize the experience of surgical treatment for patients with deep vein thrombosis(DVT) of the lower extremity.Methods:Thirty two patients with DVT were diagnosed by ascending lower extremity deep vine angiography or color Doppler ultrasonic examination.All the patients were performed embolectomy with Fogarty.Twenty nine cases underwent reconstruction,of whom,3 were performed Palma Dell operation and 26 communis iliac vein femord vein transplantion trans current.The anticoagulant and thrombolytic therapy was used during and after the operation.Results:The swelling in 17 cases(18 lower limbs) faded away completely after operation and the swelling in 9 cases faded away after exerxises.Three cases recurred.The success rate was 16/26(64%) in the acute patients and 4/11(36.3%) in the chronic patients.One patient died of pulmonary embolism.Conclusions:DVT combined with reconstruction was effective for treatment of patient with acute deep vein thrombosis of the lower extremity.Measures should be taken to prevent recurrence after operation.