急性下肢深静脉血栓溶栓与取栓疗效分析

目的探讨下肢深静脉血栓形成(Deep venous thrombosis,DVT)患者药物间接导向溶栓治疗和手术取栓的疗效,为DVT的治疗提供参考依据。方法下肢DVT患者共80例。发病<7 d 48例中,手术治疗25例(手术组),药物溶栓治疗23例(药物组1);发病>7 d 32例(药物组2)均采用药物溶栓法。手术治疗组25例,采用Fogarty导管取栓;药物治疗55例采用尿激酶间接导向溶栓治疗。结果手术取栓25例,16例发病时间<3 d者,临床治愈率为93.8%,显效率为6.2%;另9例发病3～7 d取栓者中,临床治愈率为55.6%,显效率为44.4%;不同发病时间疗效差异有统计学意义(P<0.05)。药物溶栓组55例,临床治愈率为21.8%,显效率为40.0%,进步率为38.2%,不同发病时间之间疗效比较,差异有统计学意义(P<0.05)。手术组与药物组1疗效比较,差异亦有统计学意义(P<0.05)。药物组发生血栓形成后综合征36.0%(18/50),手术组为25.0%(6/24)。结论治疗时机和方法均会影响疗效,治疗时间较早疗效越好;发病7 d内手术取栓疗效优于药物溶栓。

Evaluation the Therapeutic Results of Targeting Thrombolysis with Drugs and Embolectomy for Deep Vein Thrombosis(DVT) in Lower Extremity

Objective To explore the therapeutic results of indirect thrombolysis with drugs and embolectomy for deep vein thrombosis(DVT) in lower extremity,in order to provide evidence for the treatment of DVT.Methods 80 cases with DVT included 25 cases who accepted embolectomy with Fogarty catheter and 55 cases received indirect targeting thrombolysis with urokinase.The 55 patients were consisted of 23 cases whose course of disease less than 7 days and other 32 more than 7 days.Results In the embolectomy group,the clinical cure rate and effective rate were 93.8% and 6.2% in 16 cases whose course of disease less than 3 days,and 55.6% and 44.4% in other 9 cases whose course of disease from 3 to 7 days,respectively.Different course of disease influenced the curative effects(P<0.05).In the thrombolysis group,the cure rate,effective and improved rate were 21.8%,40.0% and 38.2%,respectively.There was statistically significant difference in curative effects along with various courses of disease.Compared the embolectomy group with the thrombolysis group whose course less than 7 days,there was significant difference in curative effect.The incidence rates of post-thrombogenesis syndrome were 36.0%(18/50) in the embolectomy group and 25%(6/24) in the thrombolysis with drugs.Conclusion The time and means of therapy could impact on the curative effectiveness of DVT,which would be treated as early as possible.The embolectomy performed within 7 days of DVT could get better results than indirect targeting thrombolysis with drugs.