临床外科杂志 ›› 2021, Vol. 29 ›› Issue (8): 770-773.doi: 10.3969/j.issn.1005-6483.2021.08.022

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AngioJet血栓抽吸术与置管溶栓术治疗深静脉血栓形成对比研究

  

  1. 华中科技大学同济医学院附属协和医院血管外科
  • 出版日期:2021-08-20 发布日期:2021-08-20

A comparative study of Angiojet mechanical thrombectomy and catheter directed thrombolysis in the treatment of DVT

  • Online:2021-08-20 Published:2021-08-20

摘要: 目的:比较机械血栓抽吸术和置管溶栓术治疗急性下肢深静脉血栓的有效性和安全性。方法:选取我院血管外科2018年2月~2019年2月的下肢深静脉血栓病人80例,根据治疗方案不同分为机械血栓抽吸组和置管溶栓组。分析两组静脉通畅率、D二聚体、并发症、尿激酶总使用量以及住院时间。结果:机械血栓抽吸组和置管溶栓组的术后静脉通畅评分分别为(1.90±1.02)和(2.16±1.10),静脉通畅率分别为(85.84±11.48)%和(84.40±14.71)%,住院总时间分别为(13.57±4.76)天和(12.98±4.55)天,治疗期间均出现少量不同程度各类并发症(包括出血、感染、过敏等),两组比较差异无统计学意义(P>0.05)。两组D二聚体降至正常值时间分别为(6.30±1.23)天和(8.2±1.59)天,尿激酶总使用量分别为(22.6±3.4)万单位和(278.4±103.5)万单位,住院总费用分别为(9.4±3.1)万和(4.7±2.3)万,两组比较差异有统计学意义(P<0.05)。结论:机械血栓抽吸术及置管溶栓术在围术期均体现出良好的安全性,均能短时间内有效清除血栓,机械血栓抽吸术组住院时间短、溶栓药物使用更少、D二聚体下降更快,但费用增加。

关键词: 深静脉血栓形成, 机械血栓抽吸术, 置管溶栓术

Abstract: Objective:To analyze and compare the efficacy and safety of percutaneous mechanical thrombectomy and catheter directed thrombolysis in the treatment of acute deep venous thrombosis of lower limbs.Method:Eighty patients with lower extremity deep vein thrombosis in the Department of Vascular Surgery of our hospital from February 2018 to February 2019 were selected,and divided into percutaneous mechanical thrombectomy group and catheter directed thrombolysis group according to treatment regiments.The venous patency rate,Ddimer,complications,total usage of urokinase and length of hospital stay were analyzed in the two groups.Result:Comparison of percutaneous mechanical thrombectomy group and catheter directed thrombolysis group:Postoperative venous patency score was compared as(1.90±1.02)VS(2.16±1.10),the comparison of vein patency rate was was compared as:(85.84±11.48)% VS(84.40±14.71)%(P>0.05).The time for Ddimer to drop to normal value:(6.30±1.23) vs(8.2±1.59) days(P<0.05).A small amount of various complications(including bleeding,infection,allergy,etc.) occurred during the treatment,and the differences were not statistically significant(P>0.05).Total use of urokinase:(226±34) 10,000 units of VS(278.4±103.5) 10 000 units,the results showed significant difference(P<0.05).Total length of stay:(13.57±4.76) days vs(12.98±4.55) days(P>0.05).Total hospitalization cost:(9.4±3.1) VS(4.7±2.3) 10 000 Yuan,the results showed significant difference(P<0.05).Conclusion:Two groups showed good safety during perioperative period and could effectively clear thrombus within a short period of time.In the percutaneous mechanical thrombectomy group,the hospital stay was shorter,the use of thrombolytic drugs was less,and the Ddimer decreased faster,but the cost increased.

Key words: deep venous thrombosis, percutaneous mechanical thrombectomy, catheter directed thrombolysis

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