不同入路置管溶栓治疗下肢深静脉 血栓的疗效比较

Comparative analysis of catheter-directed thrombolysis by different approaches in treating deep venous thrombosis of lower extremities

摘要:

目的 比较经患侧腘静脉、经患侧大隐静脉及经健侧股静脉3 种入路方式的置管溶栓（CDT）治 疗下肢深静脉血栓形成（DVT）的临床效果。方法 选取2015 年3 月-2017 年3 月该院收治的DVT 患者75 例， 所有患者均采用CDT 治疗方法。按照置管入路的不同分为腘静脉组、大隐静脉组及股静脉组，每组各25 例。 比较3 种入路方式患侧下肢大腿和小腿的肢体消肿率、通畅改善度及并发症发生率。结果 3 组患侧下肢大腿 和小腿的肢体消肿率、通畅改善度及并发症发生率比较差异均无统计学意义（P >0.05）。结论 选择3 种入路 方式治疗DVT 对DVT 患者均可获得较好的临床效果。一般情况下，尽量选择较易穿刺的患侧腘静脉和患侧 大隐静脉入路；如若未成功，可考虑经健侧股静脉入路。

Abstract:

Objective To compare the clinical effect of catheter-directed thrombolysis (CDT) in treating deep venous thrombosis (DVT) of lower extremities through the ipsilateral popliteal vein, the ipsilateral great saphenous vein and the contralateral femoral vein. Method Totally 75 patients with DVT treated with CDT were selected from March 2015 to March 2017 in our hospital. According to the different approaches of CDT, the patients were divided into the ipsilateral popliteal vein group, the ipsilateral great saphenous vein group and the contralateral femoral vein group, 25 cases for each one. Ipsilateral lower extremity swelling rate, degree of smooth improvement and incidence of complications of the three approaches were compared. Results There were no significant differences in all the factors above among the groups (P > 0.05). Conclusion Good clinical effect can be achieved through the three approaches of CDT for DVT patients. Generally, more easily punctured approach through the ipsilateral popliteal vein or ipsilateral large saphenous vein can be chosen in advance, otherwise, approach through the contralateral femoral vein can be considered.