【摘要】 目的:对比单纯抗凝(anticoagulation,AC)与接触性导管溶栓联合抗凝(catheter-directed thrombolysis,CDT)治疗下肢深静脉血栓(DVT)的效果。方法:选取本院2011年5月-2013年9月收治的139例DVT患者,根据随机数字表法分为AC组(n=66)与CDT+AC组(n=73),观察两组溶栓效果、不良反应、血栓后综合症(PTS)和生活质量情况。结果:两组患者在治疗期间和治疗结束后均无严重的不良反应发生,其中CDT组有2例穿刺处血肿,1例血尿,2例牙龈出血;AC组有1例牙龈出血,1例血肿。与AC组相比,CDT+AC组患者中Ⅰ级溶解的人数显著降低(60.61%vs 9.59%)(P<0.05),Ⅲ级溶解的人数显著升高(7.57%vs 49.31%)(P<0.05)。随访期间,两组的PTS发病率均呈逐渐增高趋势,但无1例患者出现重度PTS。CDT+AC组患者在第12个月和18个月时的PTS发病率均较AC组显著降低(17.81%vs 33.33%,24.66%vs 43.94%)(P<0.05)。与AC组相比,CDT+AC组在第6个月、12个月及18个月时生理职能和活力评分均显著升高(P<0.05)。结论:接触性导管溶栓联合单纯抗凝治疗下肢深静脉血栓形成疗效显著,安全性高,而且有利于患者生活质量的改善。更多还原

【Abstract】 Objective: To investigate the therapeutic efficacy of anticoagulation(AC) and its combination with catheterdirected thrombolysis(CDT) for deep venous thrombosis of lower extremities. Methods: One hundred and thirty-nine patients with deep venous thrombosis of early lower extremities treated in our hospital from May 2011 to September 2013 were selected and randomly divided into the AC group(n = 66) and CDT + AC group(n = 73). The thrombolytic effects,adverse reactions,post-thrombotic syndrome( PTS) and quality of life were evaluated. Results: There were no serious adverse events during treatment and after treatment in the 2 groups. Hematomas in 2 cases and gross hematuria in 3 cases were observed in the CDT + AC group. The gums bleed or gross hematuria in 3 cases were observed in the AC group.Compared with the AC group,the number of grade Ⅰ thrombolysis in CDT + AC group decreased significantly(60. 61%vs 9. 59%)(P < 0. 05),and the number of grade Ⅲ thrombolysis increased significantly(7. 57% vs 49. 31%)( P <0. 05). During follow-up,the incidence of PTS in both groups showed increase year by year,and none of the patients had severe PTS. The incidence PTS in CDT + AC group at 12 months and 18 months were lower than those of AC group(17. 81% vs 33. 33%,24. 66% vs 43. 94%)(P < 0. 05). Compared with the AC group,the scores of physiological role and vitality in CDT + AC group at 6 months,12 months and 18 months were higher(P < 0. 05). Conclusion: Catheterdirected thrombolysis combined with AC therapy can promote the mitigation of clinical symptoms in patients with DVT of lower extremities and is beneficial to promoting the life quality of patients.更多还原