[1]刘 强,程英升,王永利.D- 二聚体及纤维蛋白原监测在导管接触溶栓治疗急性下肢深静脉血栓形成中的应用 [J].介入放射学杂志,2018,27(11):1031-1035.
 LIU Qiang,CHENG Yingsheng,WANG Yongli..The application of monitoring of plasma D- dimer and fibrinogen concentrations in treating acute lower extremity deep venous thrombosis with catheter- directed thrombolysis[J].journal interventional radiology,2018,27(11):1031-1035.
点击复制

D- 二聚体及纤维蛋白原监测在导管接触溶栓治疗急性下肢深静脉血栓形成中的应用
()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
27
期数:
2018年11期
页码:
1031-1035
栏目:
血管介入
出版日期:
2018-11-25

文章信息/Info

Title:
The application of monitoring of plasma D- dimer and fibrinogen concentrations in treating acute lower extremity deep venous thrombosis with catheter- directed thrombolysis
作者:
刘 强 程英升 王永利
Author(s):
LIU Qiang CHENG Yingsheng WANG Yongli.
Department of Interventional Radiology, Affiliated Sixth People’s Hospital, Shanghai Jiaotong University, Shanghai 200233, China
关键词:
【关键词】 下肢深静脉血栓形成 导管接触溶栓 D-二聚体 纤维蛋白原
文献标志码:
A
摘要:
【摘要】 目的 分析急性下肢深静脉血栓形成(LEDVT)导管接触溶栓(CDT)过程中血浆D- 二聚体(D- D)、纤维蛋白原(FIB)值变化,评估其临床应用价值。方法 选取2015年12月至 2016年12月采用CDT治疗的18例急性LEDVT患者,溶栓前、开始后每隔8 h、结束时检测患者血浆D- D、FIB值。计算D- D峰值、上升速度,FIB下降速度,D- D增高时间及血栓溶解率并予疗效分级。Pearson相关系数分析D- D、FIB值变化规律,D- D峰值与血栓量、D- D上升速度与血栓溶解率、D- D上升速度与FIB下降速度、D- D增高时间与血栓溶解率相关性。结果 18例患者平均血栓溶解率为78%,6例血栓完全溶解。疗效分级优、良13例(72.2%),未发生颅内出血等严重并发症。术中尿激酶剂量不变情况下D- D值先升后降,FIB值持续下降,尿激酶剂量减半后D- D值下降变缓,FIB值逐渐上升。D- D峰值与血栓量呈正相关(r=0.81,P<0.01),D- D上升速度与FIB下降速度呈正相关(r=0.49,P=0.04),D- D上升速度与血栓溶解率呈负相关(r=0.08,P=0.08);D- D增高时间与血栓溶解率呈负相关(r=-0.35,P=0.16)。结论 CDT治疗急性LEDVT过程中监测分析血浆D- D、FIB,有助于指导溶栓药物应用,延长溶栓时间,提高CDT治疗效果。

参考文献/References:

[1] Jiang K, Li XQ, Sang HF, et al. Mid- term outcome of endovascular treatment for acute lower extremity deep venous thrombosis[J]. Phlebology, 2017, 32: 200- 206.
[2] 王 耿, 李孝虎, 庄佩佩, 等. 可回收下腔静脉滤器联合导管持续溶栓治疗急性下肢深静脉血栓形成[J]. 介入放射学杂志, 2016, 25: 171- 174.
[3] Duan PF, Ni CF. Randomized study of different approaches for catheter- directed thrombolysis for lower- extremity acute deep venous thrombosis[J]. J Formos Med Assoc, 2015, 115: 652- 657.
[4] 中华医学会放射学分会介入学组. 下肢深静脉血栓形成介入治疗规范的专家共识[J]. 介入放射学杂志, 2011, 20: 505- 510.
[5] 中华医学会外科学分会血管外科学组. 深静脉血栓形成的诊断和治疗指南(第二版). 中国血管外科杂志·电子版, 2013, 5: 23- 26.
[6] Kearon C, Akl EA, Ornelas J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report[J]. Chest, 2016, 149: 315- 352.
[7] 赵伯翔, 顾建平, 陈国平, 等. D- 二聚体监测在治疗急性髂股静脉血栓形成中的临床价值[J]. 介入放射学杂志, 2013, 22: 464- 469.
[8] 代雪娜. 不同溶栓方式治疗下肢深静脉血栓过程中血浆 D- 二聚体的变化及意义[J]. 现代预防医学, 2011, 38: 3790- 3792.
[9] Mewissen MW, Seabrook GR, Meissner MH, et al. Catheter- directed thrombolysis for lower extremity deep vein thrombosis: report of a national multi- center registry[J]. Radiology, 1999, 211: 39- 49.

相似文献/References:

[1]薛清泉,胡骥琼,司春强,等. 超声引导下置管溶栓治疗下肢深静脉血栓[J].介入放射学杂志,2012,(02):115.
 XUE Qing-quan,HU Ji-qiong,SI Chun-qiang,et al.Ultrasound-guided catheter-directed thrombolysis for deep venous thrombosis of lower extremity[J].journal interventional radiology,2012,(11):115.
[2]郝红军,李 智,金泳海,等. 球囊扩张辅助经导管直接溶栓导致下腔静脉滤器栓塞及其处理[J].介入放射学杂志,2012,(06):461.
 HAO Hong- jun,LI Zhi,JIN Yong-hai,et al. Inferior vena cava filter embolism caused by balloon?蛳assisted catheter?蛳directed thrombolysis and its treatment[J].journal interventional radiology,2012,(11):461.
[3]中国医师协会介入医师分会,中华医学会放射学分会介入专业委员会,中国静脉介入联盟.下肢深静脉血栓形成介入治疗规范的专家共识(第2版)[J].介入放射学杂志,2019,28(01):1.
 Interventional Physicians Branch of Chinese Medical Doctor Association,Intervention Professional Committee of Chinese Medical Association Radiology Branch,Chinese Intravenous Intervention Union.Expert consensus on the standard of interventional therapy for lower extremity deep venous thrombosis(second edition)[J].journal interventional radiology,2019,28(11):1.
[4]施洪峰,肖 颖,隋守光,等.Cook腔静脉滤器回收时机探讨[J].介入放射学杂志,2015,(10):906.
 SHI Hong- feng,XIAO Ying,SUI Shou- guang,et al.Discussion on the optimal retrieval time of Cook Medical inferior vena cava filters[J].journal interventional radiology,2015,(11):906.
[5]刘玉金,张孝军,宋伟祥,等.尿激酶经导管接触溶栓治疗急性肢体缺血初步临床应用 [J].介入放射学杂志,2018,27(03):262.
 LIU Yujin,ZHANG Xiaojun,SONG Weixiang,et al.Preliminary clinical application of catheter- directed thrombolysis with urokinase for acute limb ischemia[J].journal interventional radiology,2018,27(11):262.
[6]朱 军,戴真煜,姚立正,等.AngioJet药物机械偶联血栓清除术治疗急性下肢深静脉血栓形成 [J].介入放射学杂志,2017,(06):518.
 ZHU Jun,DAI Zhenyu,YAO Lizheng,et al.AngioJet rheolytic thrombectomy for the treatment of acute deep venous thrombosis of lower extremity[J].journal interventional radiology,2017,(11):518.
[7]李 燕,陈婷婷,尹媛媛,等.下肢深静脉血栓溶栓治疗中两种气囊压力带辅助应用的对照研究 [J].介入放射学杂志,2017,(11):1042.
 LI Yan,CHEN Tingting,YIN Yuanyuan,et al.Air pressure cuff- assisted thrombolytic therapy in treating deep venous thrombosis of lower extremity: a comparison study of two kinds of air pressure cuff[J].journal interventional radiology,2017,(11):1042.
[8]彭义盛,楼文胜,顾建平,等.改良手动抽吸治疗急性髂股静脉血栓形成对照研究[J].介入放射学杂志,2018,27(06):510.
 PENG Yisheng,LOU Wensheng,GU Jianping,et al.Modified manual aspiration thrombectomy for the treatment of acute iliofemroal deep vein thrombosis: a comparative study[J].journal interventional radiology,2018,27(11):510.
[9]刘 强,程英升,王永利.腔内血栓清除治疗急性下肢深静脉血栓形成研究进展[J].介入放射学杂志,2018,27(08):797.
 LIU Qiang,CHENG Yingsheng,WANG Yongli.Endovascular thrombus clearance for the treatment of acute lower extremity deep venous thrombosis: recent progress in research[J].journal interventional radiology,2018,27(11):797.
[10]王孝运,段鹏飞,倪才方.下肢深静脉血栓形成伴髂静脉狭窄支架植入与否近中期临床疗效比较 [J].介入放射学杂志,2018,27(12):1140.
 WANG Xiaoyun,DUAN Pengfei,NI Caifang.Use vs not use of stent implantation in treating deep venous thrombosis of the lower extremities associated with iliac vein stenosis: comparison of clinical mid- term efficacy[J].journal interventional radiology,2018,27(11):1140.
[11]孙亚鹏,金泳海,樊宝瑞,等.髂静脉重度狭窄继发急性左下肢深静脉血栓形成——支架植入时机研究 [J].介入放射学杂志,2019,28(01):23.
 SUN Yapeng,JIN Yonghai,FAN Baorui,et al.Acute deep vein thrombosis of left lower extremity secondary to severe iliac vein stenosis: clinical study on the optimal timing to perform stent implantation[J].journal interventional radiology,2019,28(11):23.
[12]刘 强,王永利,王征宇,等.导管接触溶栓治疗急性下肢深静脉血栓形成时D-二聚体和纤维蛋白原变化规律 [J].介入放射学杂志,2019,28(05):421.
 LIU Qiang,WANG Yongli,WANG Zhengyu,et al.Study on the changes of plasma D- dimmer and fibrinogen concentrations in catheter- directed thrombolysis for acute lower extremity deep venous thrombosis[J].journal interventional radiology,2019,28(11):421.
[13]张慧敏,殷世武,陈 君,等.赋权用于下肢深静脉血栓形成导管溶栓治疗患者早期康复活动的效果[J].介入放射学杂志,2024,33(05):554.
 ZHANG Huimin,YIN Shiwu,CHEN Jun,et al.Application of patient empowerment in early rehabilitation training for patients with deep vein thrombosis after receiving catheter-directed thrombolysis[J].journal interventional radiology,2024,33(11):554.
[14]渠艳艳,卫志庆,石红建,等.股静脉及胫前静脉入路导管接触溶栓治疗急性下肢深静脉血栓形成患者近期效果和安全性观察[J].介入放射学杂志,2024,33(07):774.
 QU Yanyan,WEI Zhiqin,SHI Hongjian,et al.The short-term efficacy and safety of catheter-directed thrombolysis via femoral vein and anterior tibial vein access for acute lower extremity deep vein thrombosis[J].journal interventional radiology,2024,33(11):774.

备注/Memo

备注/Memo:
(收稿日期:2017-12-26)
(本文编辑:边 佶)
更新日期/Last Update: 2018-11-16