【摘要】 目的对溶栓药物在治疗下肢深静脉血栓形成(LD-VT)中的相关问题进行探讨。方法回顾性分析我科379例行抗凝、祛聚、溶栓的综合药物治疗的LDVT患者,根据发病时期不同将患者分为急性期(≤3 d)、亚急性期(3～14 d)和慢性期(>14 d),再根据使用药物组合的不同分别将3组分为两个亚组:抗凝祛聚组和溶栓抗凝祛聚组。将158例术后发生LDVT的患者亦分为抗凝祛聚组和溶栓抗凝祛聚组。结果药物治疗对于急性期患者的治疗效果最好,在亚急性期及慢性期的两个亚组间比较,溶栓抗凝祛聚治疗的临床疗效均明显好于抗凝祛聚治疗,差异有显著性(P<0.01),两组间凝血指标及相关并发症的发生率差异无显著性。在158例术后并发LDVT患者中,溶栓抗凝祛聚治疗的效果明显好于抗凝祛聚治疗,差异有显著性(P<0.01);两组间凝血指标及相关并发症的发生率差异无显著性。结论溶栓药物对急性期LDVT患者治疗效果最好,对亚急性期和慢性期患者仍然有效。对于术后LDVT患者在严密观测下使用常规剂量溶栓药物治疗是安全有效的。更多还原

【Abstract】 Objective To discuss the thrombolytic agents in the treatment of lower extremity deep venous thrombosis(LDVT).Methods We summarized a retrospective analysis of 379 patients with LDVT treated in our hospital who were combined therapy with thrombolysis,anticoagulation and anti-platelet adhesion.We divided the 379 cases into three groups:acute stage(≤3 d),subacute stage(3～14 d) and chronic stage(>14 d) group according to disease period.Each group was further divided into two sub-groups according to therapeutic protocol:thrombolysis plus anti-coagulation,anti-platelet adhesion and anticoagulation plus anti-platelet adhesion.Results Patients in acute stage had the best clinical efficacy of thrombolysis plus anticoagulation and anti-platelet adhesion.The clinical efficacy of thrombolysis plus anticoagulation and anti-platelet adhesion was more effectual than anticoagulation plus anti-platelet adhesion to patients in subacute and chronic stage(P<0.01).The 158 LDVT patients of postoperations had better effect with thrombolysis plus anticoagulation and anti-platelet adhesion than anticoagulation plus anti-platelet adhesion(P<0.01) and the complications was indifference.Conclusion Combined therapy with thrombolysis,anticoagulation,and anti-platelet adhesion therapy is primary treatment of LDVT.Thrombolysis plus anticoagulation and anti-platelet adhesion treatment is effective for patients in non-acute stage,and which is an effective and safe method for postoperative LDVT under the tight monitoring.更多还原