本文關(guān)鍵詞： 深靜脈血栓形成 下腔靜脈濾器 置管溶栓 足背靜脈溶栓　出處：《安徽醫(yī)科大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:在下腔靜脈濾器保護(hù)下,使用置管溶栓與足背靜脈溶栓這兩種不同的溶栓方法治療下肢深靜脈血栓形成(DVT),對(duì)比這兩種溶栓方法的早期臨床療效。方法:選擇我院普外科2012年6月至2014年6月下肢DVT患者,其中符合既往無(wú)DVT發(fā)生病史、深靜脈血栓發(fā)生時(shí)間在1周內(nèi),且因病情需要行溶栓治療并同意治療的86例患者作為研究對(duì)象。隨機(jī)分為足背靜脈溶栓組(N=36)與導(dǎo)管溶栓組(N=48)。通過(guò)靜脈通暢率及臨床癥狀改善情況評(píng)價(jià)其早期療效。結(jié)果:86例患者中,2例患者植入下腔靜脈濾器失敗故未開(kāi)始溶栓治療,84例患者植入成功,48例置入導(dǎo)管溶栓的患者治療時(shí),43例患者3天時(shí)患肢腫脹明顯消退,37例患者一周基本恢復(fù)正常;2周時(shí)患肢靜脈通暢率為77.1%,而采用足背靜脈溶栓治療的36例患者,16例患者3天時(shí)患肢腫脹明顯消退,9例患者一周基本恢復(fù)正常;2周時(shí)患肢靜脈通暢率為25%,靜脈通暢率置管溶栓患者組高于足背靜脈溶栓組;術(shù)前兩組患者的周徑差對(duì)比無(wú)統(tǒng)計(jì)學(xué)意義(P0.05),術(shù)后兩組患者第3天、1周、2周時(shí)患肢與健肢的周徑差,較之術(shù)前明顯降低(P值分別為0.003、0.001、0.002),且置管溶栓組患肢與健肢周徑差明顯低于經(jīng)足背靜脈溶栓組,兩組相比差異有統(tǒng)計(jì)學(xué)意義(P0.01)。在靜脈通暢度方面,置管溶栓組的77%亦遠(yuǎn)高于足背靜脈溶栓組的25%。結(jié)論:在下腔靜脈濾器保護(hù)下,應(yīng)用足背靜脈溶栓治療DVT可取得一定療效,但應(yīng)用置管溶栓能更加迅速的改善下肢靜脈回流障礙,靜脈通暢率提高明顯,較之足背靜脈溶栓早期療效更加顯著。
[Abstract]:Objective: under the protection of inferior vena cava filter, Two different thrombolytic methods, catheterization thrombolytic therapy and dorsal foot venous thrombolytic therapy, were used to treat DVT of deep vein thrombosis of lower extremity. The early clinical effects of these two methods were compared. Methods: from June 2012 to June 2014, the patients with DVT of lower extremity in our hospital were selected. There was no history of DVT, and the time of occurrence of deep venous thrombosis was within 1 week. 86 patients who needed thrombolytic therapy and agreed to the treatment were randomly divided into dorsal foot thrombolytic group (n = 36) and catheter thrombolytic group (n = 48). The early curative effect was evaluated by the rate of patency of vein and the improvement of clinical symptoms. Results of 86 cases, 2 cases failed to implant inferior vena cava filter, 84 cases failed to start thrombolytic therapy. 48 cases successfully implanted catheter thrombolytic therapy. 43 cases of patients with thrombolytic therapy were treated with thrombolytic catheter for 3 days. The swelling of the affected limbs subsided obviously. 37 cases suffered from thrombolytic therapy. The patency rate of the affected limb vein was 77.1 at 2 weeks, while 36 patients with thrombolytic therapy of dorsalis pedis vein were treated with thrombolytic therapy for 3 days. The swelling of the affected limb disappeared significantly in 3 days. In 9 patients, the normal limb became normal at 2 weeks after thrombolytic therapy. The vein patency rate was 25%, the venous patency rate in the thrombolytic group was higher than that in the dorsal foot-vein thrombolytic group. There was no significant difference in the circumference difference between the two groups before operation (P 0.05). The difference of the circumference between the affected limb and the healthy limb at the 3rd day and the 2nd week after operation was observed in the two groups. Compared with preoperative, the P value of thrombolytic thrombolytic group was 0.003 / 0.001 / 0.002, respectively, and the difference of circumference diameter between the affected and healthy limbs in the thrombolytic group was significantly lower than that in the thrombolytic group via dorsal foot vein, the difference between the two groups was statistically significant (P 0.01), and the patency of vein was significantly lower in the thrombolytic group than that in the control group. 77% in the thrombolytic group was significantly higher than that in the thrombolytic group in the dorsal foot-vein group. Conclusion: under the protection of inferior vena cava filter, thrombolytic therapy of the dorsal vena pedis vein can obtain certain curative effect, but the thrombolytic therapy can improve the obstruction of venous reflux in the lower extremity more quickly. The patency rate of vein increased significantly, compared with the early effect of thrombolysis on dorsal foot vein.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R654.3

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本文編號(hào)：1534137