【摘要】 目的 探讨腔内介入治疗妊娠相关急性深静脉血栓形成(DVT)的临床疗效及安全性。方法 回顾性分析妊娠相关急性DVT行腔内治疗的12例患者，通过回顾术前、术后静脉造影及血栓清除率评分评估血管再通效果。随访内容包括症状和体征变化及下肢深静脉超声检查。结果 12例患者均放置可回收下腔静脉滤器(IVCF),平均滤器取出时间(18.8±1.4)d,平均住院天数(15.8±6.3)d,术中尿激酶用量20万u,肝素用量(33.3±4.9) mg,术后平均血色素降低(8.5±2.1) g/L。Ⅰ级溶解1例(8.3%),术后改为置管溶栓术，Ⅱ级溶解2例(16.7%),Ⅲ级溶解9例(75.0%),技术成功率100%。12例患者均未置入支架，围手术期未出现肺动脉栓塞、明显出血等并发症。8例早期妊娠患者在吸栓术后4～15 d,平均(10±4)d行终止妊娠手术。2例晚期妊娠患者在IVCF保护下行经阴道分娩，产后2～4 d行血栓抽吸手术。随访至少6个月以上结果提示深静脉通畅12例(100%),均未出现深静脉血栓形成后综合征(PTS)(Villalta评分≤4分)。结论 腔内介入治疗妊娠相关急性DVT是一种安全、有效的手术方法，血栓清除效率高，并发症少。更多还原

【Abstract】 Objective To investigate the thrombus clinical curative effect and practical value in treatment of pregnancy-related acute deep venous thrombosis(DVT) by using endovascular interventional therapy.Methods Clinical data of 12 patients suffering from pregnancy-related acute DVT treated by endovascular interventional therapy were analyzed retrospectively.Venous recanalization was graded by a thrombus removal efficiency score based on pre-and post-treatment venography.Follow-up was performed by doppler ultrasound and clinical evaluation. Results All the 12 patients were planted temporary inferior vena cava filters(IVCF).The average time of temporary vena cava filters in body was(18.8±1.4) days.The average time of hospitalization was(15.8±6.3) days.The dosage of urokinase was 20×10~5 u and heparin was(33.3±4.9) mg during surgery.The average reduction of hemoglobin was(8.5±2.1) g/L.1 patient(8.3%)(grade Ⅰ thrombolysis) was converted to catheter-directed thrombolysis.There were 2 patients(16.7%) achieving grade Ⅱ and 9 patients(75.0%) achieving grade Ⅲ,respectively, technique success rate were 100%.All the 12 patients were not planted stents, no pulmonary embolism and obvious bleeding occurred during perioperative period.8 patients underwent early pregnancy termination after thrombectomy 4 days to 15 days, the average time was(10±4) days.Other 2 patients underwent vaginal delivery after thrombectomy 2 days to 4 days.After at least 6 month follow-up, deep venous was patent in all 12 cases(100%),and no patient had signs or symptoms of post thrombotic syndrome(PTS)(Villalta score≤4).Conclusion Using endovascular interventional therapy treating pregnancy-related acute DVT is a safe and effective surgical method, which has high thrombus removal efficiency and few complications.更多还原