本文關(guān)鍵詞： Cockett綜合征 深靜脈血栓 腔內(nèi)治療　出處：《中國(guó)現(xiàn)代醫(yī)學(xué)雜志》2017年19期 　論文類(lèi)型：期刊論文

【摘要】：目的分析Cockett綜合征合并急性下肢深靜脈血栓形成(DVT)的不同治療手段的療效,探討濾器植入是否常規(guī),尋找更加合理治療方法。方法回顧性分析鄭州大學(xué)第一附屬醫(yī)院2014年8月-2016年4月期間就診的89例Cockett綜合征并發(fā)急性下肢DVT患者,按治療方式分為實(shí)驗(yàn)組(A、B組)和對(duì)照組(C組)。A組36例均行下腔濾器植入+置管溶栓,其中11例行球擴(kuò),16例行球擴(kuò)+支架;B組22例均行置管溶栓,其中7例行球擴(kuò),11例行球擴(kuò)+支架,C組31例行系統(tǒng)溶栓保守治療,術(shù)后給予抗凝、活血、消腫、穿彈力襪,院外均口服華法林繼續(xù)抗凝,觀察各組治療療效及血栓相關(guān)事件發(fā)生率。結(jié)果 87例獲得隨訪,隨訪時(shí)間為3~20個(gè)月。A和B組有效率均為100%,C組有效率為80%,均未出現(xiàn)肺栓塞,無(wú)疾病相關(guān)死亡病例,實(shí)驗(yàn)組中A組與B組肺栓塞發(fā)生率及治療療效差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。實(shí)驗(yàn)組和對(duì)照組比較,實(shí)驗(yàn)組癥狀均得到明顯緩解,對(duì)照組中6例肢體緩解不明顯,療效差異有統(tǒng)計(jì)學(xué)意義(P0.05);血栓后遺癥發(fā)生率差異有統(tǒng)計(jì)學(xué)意義(P0.05),實(shí)驗(yàn)組低于對(duì)照組。結(jié)論對(duì)于Cockett綜合征合并急性期血栓治療,不常規(guī)植入下腔靜脈濾器也是安全有效的;腔內(nèi)治療較藥物系統(tǒng)溶栓中遠(yuǎn)期效果好,通暢率高,發(fā)生血栓后綜合征風(fēng)險(xiǎn)明顯降低。
[Abstract]:Objective to analyze the effect of different treatment methods on Cockett syndrome with acute deep venous thrombosis (DVT), and to investigate whether filter implantation is routine. Methods 89 patients with Cockett syndrome complicated with acute lower limb DVT from August 2014 to April 2016 in the first affiliated Hospital of Zhengzhou University were analyzed retrospectively. The patients were divided into two groups according to the treatment methods: group A (n = 36) and group C (n = 36). Thrombolytic therapy was performed in group B (n = 16), and thrombolysis was performed in group B (n = 22). Among them, 7 cases were treated with bulbar expansion, 11 cases were treated with systemic thrombolytic conservative therapy, 31 cases were treated with systemic thrombolytic conservative therapy, after operation, anticoagulant, blood circulation, detumescence, elastic socks were worn, warfarin was taken orally outside the hospital to continue anticoagulant therapy. Results 87 cases were followed up for 3 ~ 20 months. The effective rates of group A and B were 80%, no pulmonary embolism and no disease related death. There was no significant difference in the incidence and curative effect of pulmonary embolism between group A and group B. compared with control group, the symptoms of experimental group and control group were obviously relieved, and 6 cases of control group were not significantly relieved. The difference of curative effect was statistically significant (P 0.05) and the incidence of thrombotic sequelae was significantly lower in the experimental group than in the control group. Conclusion it is also safe and effective for Cockett syndrome with acute thromboembolism to implant the inferior vena cava filter. Endovascular therapy was more effective and patency than drug system thrombolytic therapy, and the risk of post-thrombotic syndrome was significantly reduced.
【作者單位】： 鄭州大學(xué)第一附屬醫(yī)院大血管外科;
【分類(lèi)號(hào)】：R543.6

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