摘要
【目的】比较插管溶栓法（CDT）与周围静脉溶栓法（AVT）治疗急性下肢深静脉血栓（LDVT）的临床疗效。【方法】选择2015年3月至2017年3月本院收治的70例急性LDVT患者为研究对象，根据治疗方式不同将其分为CDT组（n=36）和AVT组（n=34），比较两组患者术后临床疗效、静脉血管造影评价、凝血纤溶指标及并发症情况。【结果】两组术后均有显著疗效，两组患者溶栓后大小腿患一健肢周径差均明显小于溶栓前，CDT组大小腿患-健肢周径差显著小于AVT组，差异具有统计学意义（P〈0．05）；CDT组消肿率明显高于AVT组（P〈0．05）。CDT组溶栓后总评分显著低于AVT组，CDT组溶栓率明显高于AVT组，差异具有统计学意义（P〈0．05）。两组溶栓24h时D-二聚体、FDP水平均明显高于术前，溶栓结束时均明显低于溶栓24h及术前，差异具有统计学意义（PG0．05）；溶栓24h血清FIB水平明显低于术前，明显高于溶栓结束，差异具有统计学意义（P〈0．05）；CDT组同一时间血清D-二聚体、FIB、FDP水平与AVT组比较差异具有统计学意义（P〈0．05）。CDT组术后并发症总发生率为30．55％（11／36）高于AVT组的20．58％（7／34），但差异无统计学意义（r=0．91，P〉0．05）。【结论】CDT、AVT治疗急性LDVT均有较好疗效，并发症发生率无显著差异，但CDT的消肿率和溶栓率均优于AVT，更适用于LDVT的治疗。
[Objective]To compare the clinical efficacy of catheter directed thrombolysis （CDT） and peripheral ve- nous thrombolysis （AVT） in the treatment of acute lower deep vein thrombosis （LDVT）. [Methods]A total of 70 cases of patients with acute LDVT in Shuyang People＇s Hospital were collected for the study and divided into the CDT group（ n = 36, treated with inferior vena eava filter and CDT） and the AVT group（ n = 34, treated with AVT ）. The clinical effi- cacy, venous angiography, coagulation and fibrillation indexes and complications were compared between the two groups. [Results] The significant curative effects were shown in the two groups after operation. The circumference difference of legs and uninjured limb after thrombolysis was significantly smaller than that before thrombolysis （ P 〈0.05）, and the decrease rate and swelling rate of the CDT group were better than those of the AVT group （ P 〈0.05）. and the concen- trations of D-dimer and FDP at 24h of thrombolysis were significantly higher than those before operation（ P 〈0.05）, and the concentrations at the end of thrombolysis were significantly lower than those at 24h of thrombolysis or those before thrombolysis （ P 〈0.05）. And the PIB level at 24h of thrombolysis was significantly lower than that before operation（ P 〈0.05） and significantly higher than that at the end of thrombolysis （ P 〈0.05）, and the changes degrees of the above indexes in the CDT group were significantly greater than those in the AVT group. The total incidence rate of postoperative complications was 30.55% （11/36）in the CDT group and 20.58M （7/34）in the AVT group, therefore there was no sig- nificant difference in the postoperative complications between the two groups （X^2= 0.91, P 〉0.05）. [Conclusion] CDT and AVT both have good effects in the treatment of acute LDVT. There are no significant differences in the incidence rate of complications in the use of CDT and AVT, but the swelling rate and thrombolysis rate of CDT are better than those of AVT, therefore CDT is more suitable for LDVT treatment.
作者
蔡挪亚
靳秋露
陈伯华
CAI Nuo-ya, JIN Qiu-lu, CHEN Bo-hua(School of Clinical Medicine, Qin gdao University, Qingdao , Shandong 26607)
出处
《医学临床研究》
CAS
2018年第3期474-477,共4页
Journal of Clinical Research
