發(fā)布時間：2018-05-15 01:05

  本文選題：髂股靜脈 + 抗凝��； 參考：《安徽醫(yī)科大學》2015年碩士論文

【摘要】：目的應(yīng)用Meta分析研究單純系統(tǒng)抗凝(systemic anticoagulation, SA)、置管溶栓(catheter-directed thrombolysis, CDT)與血栓切除(surgical thrombectomy, ST)治療急性髂股段血栓形成(acute iliofemoral deep vein thrombosis, AIFDVT)的療效。方法選取1984年1月至2014年1月近30年間發(fā)表的10篇關(guān)于SA. ST. CDT臨床效果的隨機對照研究,應(yīng)用Meta分析評價早期血管再通率、深靜脈血栓后遺癥(post-thrombotic syndrome, PTS)發(fā)生率、血管返流(venous reflux, VR)率、管腔堵塞(venous obstruction, VO)率等相關(guān)指標。共有10篇隨機對照研究納入此分析,包括626例患者。早期血管再通率：CDT組高于SA組,差異有統(tǒng)計學意義(OR=4.61,95%CI 1.93～10.98,p=0.0006);ST組與SA組比較差異無統(tǒng)計學意義(OR=2.54,95%CI 0.49～13.24, p=0.27);術(shù)后PTS發(fā)生率：CDT組低于SA組(OR=0.18,95%CI 0.07～0.43, p=0.0002),ST組低于SA組(OR=0.50,95%CI 0.28～0.87, p=0.01),差異均有統(tǒng)計學意義；術(shù)后VR發(fā)生率：CDT組與SA組比較(OR=0.54,95%CI 0.29～1.01,p=0.05)、ST組與SA組比較(OR=0.54,95%CI 0.27～1.08,p=0.08)差異均無統(tǒng)計學意義；術(shù)后VO發(fā)生率：CDT組低于SA組,差異有統(tǒng)計學意義(OR=0.19,95%CI 0.11～0.34,p0.01),ST組與SA組比較差異無統(tǒng)計學意義(OR=1.53,95%CI 0.72～3.26,p0.27)。結(jié)論CDT治療AIFDVT的早期療效(7天)明顯優(yōu)于傳統(tǒng)的系統(tǒng)抗凝。關(guān)于遠期療效(6月),血栓切除術(shù)、置管溶栓較傳統(tǒng)的系統(tǒng)抗凝均能有效降低PTS發(fā)生率,且置管溶栓還能降低血管內(nèi)栓塞的發(fā)生率。
[Abstract]:Objective to study the efficacy of systemic anticoagulation, catheter-directed thrombolysis (CDTs) and thrombectomy in the treatment of acute iliofemoral thromboembolism (iliofemoral deep vein thrombosis, AIFDVT) by Meta analysis. Methods Ten articles about SAA from January 1984 to January 2014 were selected. ST. In a randomized controlled study of the clinical effects of CDT, Meta analysis was used to evaluate the early vascular recanalization rate, post-thrombotic syndromes (PTSs), venous reflux rate, venous obstruction rate and so on. A total of 10 randomized controlled studies were included in this analysis, including 626 patients. The recanalization rate of early blood vessels in the group of: 1: CDT was higher than that in the group of SA, and the difference was statistically significant (P < 0.01). There was no significant difference between the St group and the SA group in CI 0.490.24, p0.27.The incidence of postoperative PTS in the control group was lower than that in the SA group, and the incidence of postoperative PTS was lower than that in the control group (P 0.1895 CI 0.07 鹵0.43), and the difference was statistically significant in the control group (P 0.0002P = 0.5095 CI 0.280.87, P 0.01). There was no significant difference in the incidence of VR between the two groups, and there was no significant difference in the incidence of VR between the two groups, but the incidence of VO in the group of VO was lower than that in the group of SA, and there was no significant difference between the St group and the SA group (CI: 0.1995 CI 0.110.34) and the group of SA. There was no significant difference between the St group and the SA group in terms of CI 0.7395CI 0.723.26p0.270.27 (P = 0.27), and there was no significant difference between the St group and the SA group (P > 0.05), but there was no significant difference between the two groups in the incidence rate of VR (P < 0.05), the incidence of VO was lower than that in the group of SA (P = 0.1995), and the difference was not statistically significant between the St group and the SA group. Conclusion the early therapeutic effect of CDT on AIFDVT is better than that of traditional systemic anticoagulant. Long-term results (6 months thrombectomy and thrombolytic catheterization compared with the traditional system of anticoagulation can effectively reduce the incidence of PTS and catheter thrombolysis can also reduce the incidence of intravascular embolism.
【學位授予單位】：安徽醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R654.4

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