超声在急性下肢深静脉血栓形成局部置管溶栓中的应用价值

目的 探讨超声在急性下肢深静脉血栓形成（DVT）患者局部置管溶栓中的应用价值.方法 38例急性下肢DVT患者,术前经健侧股静脉或颈内静脉置入下腔静脉滤器.在超声定位和引导下,穿刺患侧腘静脉,置入溶栓导管.微泵持续注入尿激酶,24～48 h后超声监测.结果 超声定位下穿刺针均顺利进入腘静脉;超声引导下溶栓导管均被置入血栓合适位置,38例超声引导全部成功.治疗过程中,根据血栓消融情况,4例在超声引导下调整了溶栓导管位置.经过2～7 d溶栓治疗后行超声检查,33例基本治愈,4例好转,1例无效.无一例发生大出血和肺栓塞.结论 超声检查在急性下肢DVT患者局部置管溶栓术前诊断、术中引导、术后指导用药及疗效评估方面具有一定临床应用价值.

Application value of ultrasound in transcatheter thrombolysis of acute lower limb deep phlebothrombosis

Objective To explore the application value of ultrasound in transcatheter thrombolysis of acute lower limb deep phlebothrombosis. Methods Thirty-eight patients with acute lower limb deep phlebothrombosis were enrolled in this study, Before the operation, an inferior vena cava filter was inserted through the femoral vein or the internal jugular vein on the healthy side. Under ultrasound localization and guidance, the popliteal vein was punctured and the thrombolysis catheter was inserted, then urokinase was continuously poured by using the micro pump, 24-48 h later, ultrasonography was preformed again. Results Puncture needle was successfully inserted in the popliteal vein, and the thrombolysis catheter was placed into the suitable position. Ultrasound guidance successed in 38 patients. During the treatment, the position of the catheter was changed with ultrasound guidance according to the thrombolysis condition in 4 patients. 2 -7 d later, 33 patients were cured basically, 4 patients were improvrd, 1 patient was invalid. No massive hemorrhage or pulmonary embolism happened. Conclusion Ultrasound has important clinical value in preoperative diagnosis, intraoperative guidance, postoperative medication and curative effect evaluation of transcatheter thrombolysis in patients with acute lower limb deep phlebothrombosis.