摘要
目的探讨经皮机械性血栓切除术(PMT)与置管溶栓术(CDT)在防治血栓形成后综合征(PTS)中的作用。方法收集2018年2月至2019年2月华中科技大学同济医学院附属协和医院收治的80例患者的临床资料,按照治疗方法的不同将其分为PMT组和CDT组,每组40例。PMT组行AngioJet血栓抽吸术,CDT组行CDT。比较两组患者的小腿腿围缩小情况、消肿率、小腿腿围缩小时间及PTS的发生率。结果对健侧与患侧小腿踝部腿围周径差值、小腿最粗段腿围周径差值和膝下15 cm腿围周径差值行重复测量方差分析,结果显示,两组患者不同时间点(术前1 d及术后2、4、6 d)的差值比较,差异均有统计学意义(P时间<0.01);两组患者组间差值比较,差异均无统计学意义(P组间>0.05);两组患者的差值在组间·时间点间比较,差异均有统计学意义(P交互<0.01)。术后1周,PMT组患者下肢不同节段的消肿率高于CDT组患者(P<0.05)。PMT组小腿最粗段健侧与患侧腿围差值缩小50%的所需时间短于CDT组(P<0.01)。随访期间,两组的PTS发生情况比较,差异无统计学意义(P>0.05)。结论PMT与CDT相比,消除下肢肿胀具有一定的优势,可能为DVT患者血栓清除策略提供更优的选择。
Objective To investigate the effects of percutaneous mechanical thrombectomy(PMT)and catheter-directed thrombolysis(CDT)in the prevention and treatment of post-thrombotic syndrome(PTS).Method Clinical data of Eighty patients in the Union Hospital,TongJi Medical College,Huazhong University of Science and Technology from February 2018 to February 2019 were collected.According to different treatment methods,they were divided into PMT group(40 cases)and CDT group(40 cases).The PMT group received Angiojet thrombus aspiration,and the CDT group received CDT.The reduction value of leg circumference,the reduction rate of swelling,the reduction time of leg circumference and the incidence of PTS between the two groups were compared between the two groups.Result Repeated measurement analysis of variance was performed between the healthy side and the affected side for the peri-diameter difference of the ankle,the peri-diameter difference of the thickest leg of the leg and the peri-diameter difference of the leg at 15 cm below the knee,the results showed that there were statistically significant differences between the two groups at different time points(1 day before surgery and 2,4 and 6 days after surgery)(P<0.01).There was no statistical significance between two groups(P>0.05).The difference was statistically significant(P<0.01)at the time points and groups.One week after surgery,the lower limb swelling rate of PMT group was higher than that of CDT group(P<0.05).The time of 50%reduction of the circumference difference between the healthy and affected legs in the thickest leg in PMT group was shorter than that in CDT group(P<0.01).During the follow-up,there was no significant difference in the incidence of PTS between the two groups(P>0.05).Conclusion Compared with CDT,PMT has certain advantages in reducing lower extremity swelling,and may provide a better choice for thrombus clearance in patients with DVT.
作者
李春亭
胡可
王维慈
李毅清
胡国富
Li Chunting;Hu Ke;Wang Weici;Li Yiqing;Hu Guofu(Department of Vascular Surgery,Hubei Provincial Hospital of TCM,Wuhan 430061,Hubei,China;Department of Vascular Surgery,Union Hospital,TongJi Medical College,Huazhong University of Science and Technology,Wuhan 430022,Hubei,China)
出处
《血管与腔内血管外科杂志》
2021年第2期145-149,共5页
Journal of Vascular and Endovascular Surgery
基金
国家自然科学基金资助项目(81873529)
