摘要
目的探讨血管介入治疗在剖宫产后下肢深静脉血栓(DVT)患者中的应用效果。方法收集2020年4月至2021年8月鄂州市中心医院收治的97例剖宫产术后下肢DVT患者的临床资料,按照治疗方法的不同将其分为对照组(n=46,采用海普宁联合华法林治疗)和介入组(n=51,采用血管介入治疗)。比较两组患者临床疗效,治疗前后的下肢情况及血液流变学指标;治疗后随访6~14个月,比较两组患者深静脉血栓形成后综合征(PTS)发生情况。结果介入组患者临床总有效率为98.04%(50/51),高于对照组患者的84.78%(39/46),差异有统计学意义(P﹤0.05)。治疗后,两组患者下肢深静脉畅通评分、大腿及小腿周径差、色素沉着评分均低于本组治疗前,且介入组患者上述指标均低于对照组患者,差异均有统计学意义(P﹤0.05)。治疗后,两组患者D-二聚体(D-D)、红细胞聚集指数(RCAI)、纤维蛋白原(FIB)、血浆黏度(CP)水平均低于本组治疗前,且观察组患者上述指标均低于对照组患者,差异均有统计学意义(P﹤0.05)。介入组患者轻度PTS比例低于对照组患者,无PTS比例高于对照组患者,差异均有统计学意义(P﹤0.05)。结论血管介入治疗剖宫产术后下肢DVT患者效果优于常规西药治疗,可改善下肢深静脉畅通情况,降低大腿、小腿周径差,改善色素沉着情况及血液流变学指标,降低PTS发生率。
Objective To investigate the effect of vascular interventional therapy in patients with lower extremity deep vein thrombosis(DVT)after cesarean section.Method The clinical data of 97 patients with lower extremity DVT after cesarean section who were treated in Ezhou Central Hospital from April 2020 to August 2021 were collected.According to different treatment methods,the patients were divided into the control group(n=46,treated with Haipuning+warfarin)and the intervention group(n=51,treated with vascular intervention).The clinical efficacy,condition of lower extremity and hemorheological parameters before and after treatment were compared,and the occurrence of post-deep vein thrombosis syndrome(PTS)after 6 to 14 months of postoperative follow up was compared.Result The total effective rate of clinical treatment in the intervention group was 98.04%(50/51),higher than that in the control group of 84.78%(39/46),the difference was statistically significant(P<0.05).After treatment,the patency scores of lower extremity deep vein,thigh and calf circumference difference,and pigmentation scores in both groups were lower than those before treatment,and the above indicators of the intervention group patients were lower than those of the control group,the differences were statistically significant(P<0.05).After treatment,D-dimer(D-D),red cell assembling index(RCAI),fibrinogen(FIB),and plasma viscosity(CP)levels in both groups were lower than those before treatment,and the above indicators of the intervention group patients were lower than those of the control group,the differences were statistically significant(P<0.05).The proportion of patients with mild PTS in the intervention group was lower than that in the control group,and proportion of patients without PTS was higher than that in the control group,the differences were statistically significant(P<0.05).Conclusion Vascular interventional therapy is better than conventional western medicine treatment for patients with DVT of lower extremities after cesarean section,and can improve the patency of deep veins of lower extremities,reduce the circumference difference of thighs and calves,reduce pigmentation,and improve hemorheological parameters and reduce the incidence of PTS.
作者
岑伟
汪有新
汪甜甜
Cen Wei;Wang Youxin;Wang Tiantian(Department of Obstetrics,Ezhou Central Hospital,Ezhou 436000,Hubei,China;Department of Interventional Medicine,Ezhou Central Hospital,Ezhou 436000,Hubei,China)
出处
《血管与腔内血管外科杂志》
2023年第9期1133-1136,1139,共5页
Journal of Vascular and Endovascular Surgery
关键词
血管介入治疗
剖宫产
下肢深静脉血栓
疗效
血液流变学
vascular interventional therapy
cesarean section
lower extremity deep vein thrombosis
efficacy
hemorheology
