【摘要】 :探讨急性下肢深静脉血栓术式的改进及取栓的时机。方法 :33例经股静脉取栓。 17例经静脉顺行取栓。 8例经髂静脉顺行取栓。 33例进腹探查髂静脉 ,发现髂静脉狭窄或闭塞 30例 ,均行人工血管移植。 11例加做股动 静脉瘘。结果 :2 7例于术后 3天内下肢肿胀缓解 ,4例于术后 5～ 8天缓解 ,2例无缓解。随访 30例 ,平均 18个月 ,4例发生血栓后综合征。结论 :左髂静脉狭窄或闭塞为左下肢深静脉血栓形成的重要因素 ,应同时手术处理 ;并顺着血流方向取出髂、股、静脉内的血栓 ;手术时机应根据血栓形成的时间、术前造影的结果及溶栓、抗凝情况综合考虑。更多还原

【Abstract】 Objective:To evaluate the technic improvement and operation opportunity on the treatiment of the lower extremity deep vein thrombosis.Methods:Thirty three patients(all in left)were admitted.Femoral venous thombectomy performed in 33 cases;popliteal venous ascending thrombectomy in 17 cases;iliac venous thrombectomy in 8 cases.A full exploring of left common iliac vein at inferior vena caval bifurcation was performed in all cases.A localized obstruction or stenosis of left common iliac vein under the right common artery was detected in 30 cases and thombectomy combined with iliocaval grafting and adjuctive ateriovenous fistula was performed in 11 cases.Results:Swelling fadeaway in 3 days after operation in 27 cases,5～8 days in 4 cases and no significant improvement in 2 cases.Follow up in 30 cases,mean 18 months:post thrombosis syndrome occurs in 4 cases.Conclusions:The left iliac venous stenosis or obstruction is one of the essential factors contributing to DVT of left lower extremity.Prompt surgical treatment must deal with the lession.Ascending venous thrombectomy can relatively clear up thrombus in femoropopliteal segment and the operation opportunity is determined by thrombus age,outcome of venography as well as effect of anticoagulant and thrombolytic therapy. [更多还原