溶栓治療預(yù)防血栓形成后綜合征的臨床研究
發(fā)布時(shí)間：2018-08-26 10:46
【摘要】：研究背景下肢深靜脈血栓形成(DVT)是常見的一種血管外科疾病,具有較高的發(fā)病率和死亡率,僅少數(shù)患者可獲得痊愈,大多數(shù)血栓患者將發(fā)展為血栓形成后綜合征(PTS)。血栓形成后綜合征是下肢深靜脈血栓后期嚴(yán)重并發(fā)癥之一,有學(xué)者報(bào)道大約20%-50%的患者在兩年內(nèi)發(fā)展為PTS,其中約5%-10%的患者會(huì)發(fā)展為嚴(yán)重的PTS,即靜脈性潰瘍,嚴(yán)重影響患者生活質(zhì)量,給患者帶來很大的不便和痛苦,積極治療及預(yù)防是治療血栓后綜合征的關(guān)鍵。 目的本研究通過研究血栓形成后的Villalta評(píng)分,分析研究溶栓治療對(duì)下肢深靜脈血栓形成后綜合征的預(yù)防作用。 方法根據(jù)隨機(jī)對(duì)照原則,從我院2008年1月至2010年7月的住院患者。年齡在18-75歲的初次DVT患者,癥狀發(fā)作在21天內(nèi)納入研究。分別接受單獨(dú)的常規(guī)治療(A組)和附加溶栓組(B組)。A組給予抗凝、活血化瘀等治療,B組在A組基礎(chǔ)上給予溶栓治療,通過24個(gè)月內(nèi)Villalta評(píng)分評(píng)估的PTS發(fā)生頻率及程度。本組70例下肢深靜脈血栓中,A組28人,B組42人,B組42例患者均放置下腔靜脈濾器。結(jié)果經(jīng)積極治療后,全組70例患者,下肢腫脹得到改善,兩組治療前后健測(cè)與患側(cè)下肢周徑差(包括大腿中部及小腿中部)均有顯著性差異(P0.05)。B組與A組比較,效果更明顯,有顯著性差異(P0.05)。治療前兩組靜脈通暢度評(píng)分分別為：9.08±1.38分,9.23±1.33分,差異無統(tǒng)計(jì)學(xué)差異(P0.05)；治療后兩組靜脈通暢度評(píng)分分別為：5.17±1.24分,3.68±0.98分,有統(tǒng)計(jì)學(xué)差異(P0.05)；兩組比較,B組靜脈通暢度評(píng)分明顯低于A兩(P0.05)。本組70例患者,24月后共有53例患者完成隨訪,A組21例,B組32例,根據(jù)隨訪結(jié)果,通過Villalta評(píng)分,發(fā)生血栓形成后綜合征：A組：正常13人,輕度4人(5-9)分,中度3人(10～14)分,重度1人.(15或者潰瘍)。B組：正常23人,輕度6人,中度3人,重度0人。 結(jié)論1、溶栓治療能降低血栓后綜合征的發(fā)生,是一種治療下肢深靜脈的方法。 2. Villalta評(píng)分能從客觀及主觀上評(píng)價(jià)血栓形成后綜合征,是一種較好的血栓形成后綜合征的評(píng)估工具。
[Abstract]:Background Deep venous thrombosis (DVT) is a common vascular surgery disease with high morbidity and mortality. Only a few patients can be cured. Most of the patients will develop into post-thrombotic syndrome (PTS). Post-thrombotic syndrome is one of the serious complications in the late stage of deep venous thrombosis of the lower extremity. Some scholars report that about 20% to 50% of the patients develop PTS, within two years, and about 5- 10% of the patients develop severe PTS, that is, venous ulcer. It seriously affects the quality of life of patients and brings great inconvenience and pain to patients. Active treatment and prevention is the key to the treatment of post-thrombotic syndrome. Objective to study the preventive effect of thrombolytic therapy on deep vein thrombosis syndrome (DVI) in lower extremity by studying the Villalta score after thrombosis. Methods according to the principle of random control, the inpatients in our hospital from January 2008 to July 2010. Initial DVT patients aged 18-75 were enrolled in the study within 21 days of onset of symptoms. Group A was given anticoagulant therapy, and group B received thrombolytic therapy on the basis of group A by activating blood circulation and removing blood stasis. The frequency and degree of PTS were evaluated by Villalta score within 24 months. The inferior vena cava filter was placed in group A (n = 28), group B (n = 42), group B (n = 42) and group B (n = 42). Results after active treatment, the swelling of lower extremity was improved in 70 patients in the whole group. The difference of circumference diameter of healthy and affected lower limbs (including middle thigh and middle leg) was significantly different between the two groups before and after treatment (P0.05). Compared with group A, the effect of group B was more obvious. There was significant difference (P0.05). Before treatment, the venous patency score of the two groups was 9. 08 鹵1. 38 and 9. 23 鹵1. 33, respectively (P0.05), and after treatment, the venous patency score of the two groups was 5. 17 鹵1. 24 and 3. 68 鹵0. 98, respectively (P0.05). Venous patency score in group B was significantly lower than that in group A (P 0.05). A total of 53 patients were followed-up 24 months later. According to the follow-up results, 32 cases in group B were followed up. According to the Villalta score, 13 cases were normal, 4 cases were mild (5-9), 3 cases were moderate (1014). Group B: 23 normal, 6 mild, 3 moderate and 0 severe. Conclusion 1.Thrombolytic therapy can reduce the occurrence of post-thrombotic syndrome and is a method of treating deep vein of lower extremity. 2. Villalta score can evaluate postthrombotic syndrome objectively and subjectively, and it is a good tool for evaluating postthrombotic syndrome.
【學(xué)位授予單位】：濱州醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R543.6;R816.2
本文編號(hào)：2204633
[Abstract]:Background Deep venous thrombosis (DVT) is a common vascular surgery disease with high morbidity and mortality. Only a few patients can be cured. Most of the patients will develop into post-thrombotic syndrome (PTS). Post-thrombotic syndrome is one of the serious complications in the late stage of deep venous thrombosis of the lower extremity. Some scholars report that about 20% to 50% of the patients develop PTS, within two years, and about 5- 10% of the patients develop severe PTS, that is, venous ulcer. It seriously affects the quality of life of patients and brings great inconvenience and pain to patients. Active treatment and prevention is the key to the treatment of post-thrombotic syndrome. Objective to study the preventive effect of thrombolytic therapy on deep vein thrombosis syndrome (DVI) in lower extremity by studying the Villalta score after thrombosis. Methods according to the principle of random control, the inpatients in our hospital from January 2008 to July 2010. Initial DVT patients aged 18-75 were enrolled in the study within 21 days of onset of symptoms. Group A was given anticoagulant therapy, and group B received thrombolytic therapy on the basis of group A by activating blood circulation and removing blood stasis. The frequency and degree of PTS were evaluated by Villalta score within 24 months. The inferior vena cava filter was placed in group A (n = 28), group B (n = 42), group B (n = 42) and group B (n = 42). Results after active treatment, the swelling of lower extremity was improved in 70 patients in the whole group. The difference of circumference diameter of healthy and affected lower limbs (including middle thigh and middle leg) was significantly different between the two groups before and after treatment (P0.05). Compared with group A, the effect of group B was more obvious. There was significant difference (P0.05). Before treatment, the venous patency score of the two groups was 9. 08 鹵1. 38 and 9. 23 鹵1. 33, respectively (P0.05), and after treatment, the venous patency score of the two groups was 5. 17 鹵1. 24 and 3. 68 鹵0. 98, respectively (P0.05). Venous patency score in group B was significantly lower than that in group A (P 0.05). A total of 53 patients were followed-up 24 months later. According to the follow-up results, 32 cases in group B were followed up. According to the Villalta score, 13 cases were normal, 4 cases were mild (5-9), 3 cases were moderate (1014). Group B: 23 normal, 6 mild, 3 moderate and 0 severe. Conclusion 1.Thrombolytic therapy can reduce the occurrence of post-thrombotic syndrome and is a method of treating deep vein of lower extremity. 2. Villalta score can evaluate postthrombotic syndrome objectively and subjectively, and it is a good tool for evaluating postthrombotic syndrome.
【學(xué)位授予單位】：濱州醫(yī)學(xué)院
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R543.6;R816.2
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 彭建宏;王瓊;秦亞男;;彩色多普勒超聲診斷下肢深淺靜脈血栓形成中的價(jià)值[J];中國(guó)超聲診斷雜志;2006年07期
，本文編號(hào)：2204633
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