自制多侧孔溶栓导管经腘静脉入路治疗下肢深静脉血栓

目的探讨采用自制多侧孔溶栓导管经腘静脉入路留置溶栓的方法治疗下肢深静脉血栓的可行性及有效性。方法分析96例采用腘静脉顺行法穿刺留置导管溶栓治疗的下肢深静脉血栓患者的临床资料,通过治疗前后健、患肢周径差,静脉通畅率及静脉通畅评分等指标评价临床疗效。结果 96例患者介入手术技术成功率100%,术后经过5~14天留置导管溶栓后血栓大部分溶解,下肢肿胀消退;在手术及治疗过程中无严重并发症发生,溶栓治疗结束后双下肢周径差≤1.5cm,术后静脉通畅评分较术前明显改善[(9.71±2.42)分vs(3.41±1.92)分,Z=1.72,P0.05)],静脉通畅率为(71.42±14.13)%。82例患者通过3~12个月的随访,平均随访(5.11±3.33)个月,通过超声及临床症状体征的评估,介入治疗的有效率为95.12%(78/82)。结论采用经腘静脉入路留置自制溶栓导管是治疗下肢深静脉血栓的有效方法,成功率较高、术后并发症较少,其中远期效果有待进一步随访观察。

Self-made multi-side hole catheter by popliteal approach in treatment of deep vein thrombosis

Objective To investigate the feasibility and effectiveness of self-made multi-lateral hole catheter by popliteal approach in treatment of deep vein thrombosis (DVT). Methods Clinical data of 96 patients with DVT about the contralateral, ipsilateral circumference difference, venous patency and venous patency score indicators by using antegrade popliteal vein puncture and catheter thrombolysis were analyzed retrospectively. Results Technical success rate of intervention care in 96 patients were 100%. 5-14 days after thrombolysis catheter, thrombosis were substantially dissolved, leg swelling; No serious complications occurred, and after the end of thrombolytic therapy of lower limbs, diameter difference was no more than 1.5 cm. Compared with preoperative venous patency scores, postoperative venous patency scores were significantly improved ([9.71±2.42] vs [3.41±1.92], Z=1.72, P<0.05), venous patency rate was (71.42±14.13)%. 82 patients were followed-up by 3 to 12 months, the interventional therapy effective rate was 95.12% (78/82) by using ultrasound and assessment of clinical symptoms and signs. Conclusion Self-made multi-side hole catheter by popliteal approach in treatment of DVT is effective, and the long-term effects need further follow-up observation.