[1]张希全,王义平,潘晶晶,等.手动机械性血栓碎吸治疗急性下肢深静脉血栓疗效[J].介入放射学杂志,2013,(01):20-026.
 ZHANG Xi? quan,WANG Yi? ping,PAN Jing? jing,et al. The clinical effectiveness of manually mechanical aspiration thrombectomy for the treatment of acute deep venous thrombosis of lower extremities[J].journal interventional radiology,2013,(01):20-026.
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手动机械性血栓碎吸治疗急性下肢深静脉血栓疗效 ()

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

卷:
期数:
2013年01期
页码:
20-026
栏目:
血管介入
出版日期:
2013-01-25

文章信息/Info

Title:
 The clinical effectiveness of manually mechanical aspiration thrombectomy for the treatment of acute deep venous thrombosis of lower extremities
作者:
张希全 王义平 潘晶晶 朱 伟 李长海 郭 锋 董 戈张 清
Author(s):
 ZHANG Xi?蛳 quan WANG Yi?蛳 ping PAN Jing?蛳 jing ZHU Wei LI Chang?蛳 hai GUO Feng DONG Ge ZHANG Qing.
 Department of Endovascular Interventional Therapy, No.148 Hospital of Chinese People’s Liberation Army, Zibo, Shandong Province 255300, China
关键词:
 【关键词】 静脉血栓形成 机械性血栓抽吸 溶栓治疗 介入治疗
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(lower extremity deep venous thrombosis,LEDVT)的解剖部位,评价手动机械性血栓碎吸治疗的中、长期疗效。方法 回顾分析1998年4月至2011年3月745例急性LEDVT机械性血栓碎吸治疗的临床资料。根据静脉造影显示的血栓解剖部位,分为中央型258例(A组),混合型487例(B组),经健侧股静脉安置下腔静脉滤器,患侧股静脉插入8 ~ 14 F鞘管手动机械性碎吸血栓。287例合并髂总静脉狭窄或闭塞,采取经皮血管腔内成形术和支架植入处理。随访16 ~147个月,平均(46 ± 39)个月,根据临床症状及造影复查,评价两组患者的治疗效果。结果 出院时健、患肢膝上、下15 cm处周径差A组分别为(1.34 ± 1.07)和(0.93 ± 0.52)cm,B组分别为(2.89 ± 1.53)和(1.72 ± 0.89)cm,与术前比较差异均有统计学意义(t = 19.46、24.13,P = 0.000、0.000和t = 16.14、17.79,P = 0.000、0.000)。随访发现患肢膝下15 cm处周径差A组下降为(0.53 ± 0.42)cm,B组为(1.42 ± 1.35)cm,组间差异有统计学意义(t = 13.38,P = 0.000)。水肿、色素沉着、溃疡等后遗症发生率A组分别为27.91%(72/258)、13.18%(34/258)、0%;B组分别为35.12%(171/487)、22.59%(110/487)、2.46%(12/487),组间差异有统计学意义(χ2 = 3.98,9.58,5.00,P = 0.046,0.002,0.025)。A组静脉通畅率为96.51%,瓣膜功能正常率为78.68%,B组分别为78.03%和56.47%,组间差异均有统计学意义(χ2 = 52.70、40.57,P = 0.000、0.000)。随访疗效A组优占92.64%,B组占65.09%,组间差异均有统计学意义(χ2 = 67.58,P = 0.000)。结论 急性LEDVT机械性血栓碎吸治疗,应根据血栓解剖分布类型指导治疗方案的选择;中央型单纯机械性血栓碎吸治疗效果最好,而混合型应配合系统溶栓可提高疗效。

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备注/Memo:
 (收稿日期:2012-08-02)
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