【摘要】：目的:對(duì)比單純抗凝(anticoagulation,AC)與接觸性導(dǎo)管溶栓聯(lián)合抗凝(catheter-directed thrombolysis,CDT)治療下肢深靜脈血栓(DVT)的效果。方法:選取本院2011年5月-2013年9月收治的139例DVT患者,根據(jù)隨機(jī)數(shù)字表法分為AC組(n=66)與CDT+AC組(n=73),觀察兩組溶栓效果、不良反應(yīng)、血栓后綜合癥(PTS)和生活質(zhì)量情況。結(jié)果:兩組患者在治療期間和治療結(jié)束后均無嚴(yán)重的不良反應(yīng)發(fā)生,其中CDT組有2例穿刺處血腫,1例血尿,2例牙齦出血;AC組有1例牙齦出血,1例血腫。與AC組相比,CDT+AC組患者中Ⅰ級(jí)溶解的人數(shù)顯著降低(60.61%vs 9.59%)(P0.05),Ⅲ級(jí)溶解的人數(shù)顯著升高(7.57%vs 49.31%)(P0.05)。隨訪期間,兩組的PTS發(fā)病率均呈逐漸增高趨勢(shì),但無1例患者出現(xiàn)重度PTS。CDT+AC組患者在第12個(gè)月和18個(gè)月時(shí)的PTS發(fā)病率均較AC組顯著降低(17.81%vs 33.33%,24.66%vs 43.94%)(P0.05)。與AC組相比,CDT+AC組在第6個(gè)月、12個(gè)月及18個(gè)月時(shí)生理職能和活力評(píng)分均顯著升高(P0.05)。結(jié)論:接觸性導(dǎo)管溶栓聯(lián)合單純抗凝治療下肢深靜脈血栓形成療效顯著,安全性高,而且有利于患者生活質(zhì)量的改善。
[Abstract]:Objective: to compare the effect of simple anticoagulant (anticoagulation,AC) and contact catheter thrombolysis combined with anticoagulation (catheter-directed thrombolysis,CDT) in the treatment of lower extremity deep venous thrombosis (DVT). Methods: one hundred and nine patients with DVT were selected from May 2011 to September 2013 in our hospital. According to the random digital table, they were divided into two groups: AC group (n = 66) and CDT AC group (n = 73). The effect of thrombolytic therapy, adverse reaction, (PTS) and quality of life were observed. Results: there were no serious adverse reactions during and after treatment in the two groups. In CDT group, 2 cases had hematoma, 1 case had hematuria, 2 cases had gingival hemorrhage, and 1 case had gingival hemorrhage and 1 case had hematoma in AC group. Compared with AC group, the number of grade 鈪，

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