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|本期目录/Table of Contents|

置入下腔静脉滤器联合溶栓治疗下肢深静脉血栓形成临床观察

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第4期
页码:
510-513
栏目:
临床研究
出版日期:
2012-08-25

文章信息/Info

Title:
Interventional thrombolysis combined with implantation of inferior vena cava filter in treating deep venous thrombosis of lower extremities
作者:
任 晖; 郑时康; 祝 鹏; 李 静; 巩 洁; 谢 静; 张军康
(安康市中心医院心血管内科，陕西 安康 725000)
Author(s):
REN Hui;  ZHENG Shi-kang;  ZHU Peng;  LI Jing;  GONG Jie;  XIE Jing;  ZHANG Jun-kang
(Department of Cardiology, Ankang Central Hospital, Ankang 725000, Shaanxi, China)
关键词:
下腔静脉滤器;  深静脉血栓形成; 溶栓; 肺栓塞
Keywords:
inferior vena cava filter;  deep venous thrombosis;  thrombolysis;  pulmonary embolism
分类号:
R543.6
DOI:
-
文献标识码:
A
摘要:
目的:观察置入下腔静脉滤器联合介入性溶栓治疗在下肢深静脉血栓形成中的疗效。方法： 2007年10月~2011年10月我科收治84例下肢深静脉血栓形成患者，其中51例采用下腔静脉滤器联合介入性溶栓，同时常规抗凝治疗为观察组；33例常规抗凝、溶栓治疗为对照组，观察临床变化并进行3～46个月随访。结果： 观察组在出院时治疗有效率显著高于对照组(98% vs. 58%，P<0．01)，随访3个月治疗有效率也高于对照组(98% vs. 79%，P<0.01)；观察组出血并发症较对照组显著减少（4% vs. 27%，P<0.05），静脉血栓综合征的发生率低于对照组（2% vs. 15%，P<0.05）；观察组在肺动脉栓塞发生率上有显著降低（观察组0%，对照组12%，P<0.01）。结论： 置入下腔静脉滤器联合介入性溶栓治疗下肢深静脉血栓效果优于传统溶栓治疗，能有效预防或减少肺栓塞的发生，但应严格掌握下腔静脉滤器的置入指征。
Abstract:
AIM:To evaluate the therapeutic effect of interventional thrombolysis combined with implantation of inferior vena cava filter for deep venous thrombosis of lower extremities (LEDVT). METHODS: Clinical data were analyzed in 84 patients with LEDVT from October 2008 to October 2011. Fifty one cases in the observation group were treated with interventional thrombolysis combined with implantation of inferior vena cava filter and conventional anticoagulation treatment, whereas 33 cases in the control group were treated with conventional anticoagulation and thrombolysis. The efficacy in the two groups was evaluated. RESULTS: The efficacy rates in the observation group upon hospital discharge and at 3-month follow-up were significantly higher than those in control group (98% vs. 58%; 98% vs. 79%; both P<0.01). Bleeding complications and incidence of pulmonary embolusin the observation group were significantly reduced (4% vs. 27%, P<0.05; 0% vs. 12%, P<0.01). Incidence of deep vein thrombosis syndrome in the observation group was lower than in control group (2% vs. 15%, P<0.05). CONCLUSION: Interventional thrombolysis combined with proper implantation of inferior vena cava filter for LEDVT has a superior therapeutic effect than conventional thrombolysis treatment and can effectively prevent or reduce the occurrence of pulmonary embolism.

参考文献/References

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[2]Semba CP,Dake MD.Iliofemoral deep venous thrombosis:aggressive therapy with catheter-directed thrombolysis[J].Radiology,1994,191(2):487-494.

[3]蒋劲松,施 敦,张成武,等.抗凝溶栓联合用药治疗急性下肢深静脉血栓[J].浙江实用医学,2004,9(6):391-392,401.

[4]Decousus H,Leizorovicz A,Parent F,et al.A clinical trial of vena caval filters in the prevention of pulmonary enbolism in patients with proximal deep-vein thrombosis[J].N Engl J Med,1998,338(7):409-415.

[5]Greenfild LJ,Proctor MC.Recurrent thromboembolism in patients with vena cava filters[J]. J Vasc Surg,2001,33(3):510-514.

[6]The PREPIC Study Group.Eight-year follow-up of patients with permanent vena cava filters in the prevention of pulmonary embolism:the PREPIC (Prevention du Risque d’Embolie Pulmonaire par Interruption Cave) randomized study[J].Circulation,2005,112(3):416-422.

备注/Memo

备注/Memo:
收稿日期：2012-01-29.作者简介：任晖，副主任医师Email:renhui@sina.com
更新日期/Last Update: 2012-07-20