【摘要】 目的:比较分析尿激酶经溶栓导管用不同给药方式在治疗急性中央型单侧下肢深静脉血栓形成(LEDVT)中的疗效。方法:2013年6月-2016年6月我科收治95例急性期中央型单侧LEDVT患者,按住院号末位数的奇偶分为试验组(偶数)和对照组(奇数),植入下腔静脉滤器后,49例经溶栓导管持续泵入尿激酶为对照组,46例经溶栓导管间断快速泵入尿激酶为试验组。比较溶栓前后D-二聚体(DD)浓度变化、下肢消肿、溶栓效果及并发症,随访6个月后通过Villalta评分比较两组血栓形成后综合征(PTS)情况。结果:溶栓治疗前两组DD比较差异无统计学意义(P>0.05),溶栓开始后两组DD均呈先增后降趋势,试验组在第1天达到高值,对照组在第2天达到其高值,在各检测时间点上两组DD浓度比较差异均有统计学意义(P<0.05);溶栓后大腿、小腿的周径差比较,试验组均小于对照组;试验组总有效率(74.0%)优于对照组总有效率(40.8%)。两组在并发症方面比较差异无统计学意义(P>0.05)。随访6个月后试验组PTS发生率低于对照组(P<0.05)。结论:急性期中央型单侧LEDVT经溶栓导管间断快速给药方式更能提高深静脉通畅率和降低PTS发生的风险。更多还原

【Abstract】 Objective To compare the efficacy of different ways of urokinase delivery to treat acute central unilateral lower extremity deep venous thrombosis( LEDVT) through catheter directed thrombolysis. Methods From June 2013 to June2016,95 cases of acute central unilateral LEDVT were treated in our department. According to the odd-even number of the final number of hospitalization,the patients were divided into the experimental group( even number) and the control group( odd number). After implantation of the inferior vena cava filter,49 cases in the control group were continuously administrated urokinase through thrombolysis catheter pump; 46 cases in the experimental group were rapidly and intermittently administrated urokinase through thrombolysis catheter pump. The concentrations of D-dimer( DD),swelling of the lower limbs,thrombolytic effect and complications were compared before and after thrombolytic therapy. After 6 months of follow-up,Villalta score was used to compare the situation of post thrombosis syndrome( PTS). Results There was no significant difference in DD between the two groups before thrombolytic therapy( P>0.05). After the thrombolysis,the DD of the two groups increased first and then descended. The DD of the experimental group reached a high value at the first day,and that of the control group reache a high value on the second day. The comparison of DD concentrations in the two groups at each time point was significantly different( P<0.05). After thrombolysis,the circumferential diameter of the thigh and calf in the experimental group was smaller than that in the control group,and the total effective rate in the experimental group( 74%)was better than that in the control group( 40. 8%). There was no significant difference in complications between the two groups( P>0. 05). After 6 months of follow-up,the incidence of PTS in the experimental group was lower than that in the control group( P<0.05). Conclusion Rapid and intermittent administration of thrombolysis through thrombolytic catheter can improve the patency rate of deep veins of patients with acute central unilateral LEDVT and reduce the risk of PTS.更多还原