上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2019, Vol. 39 ›› Issue (7): 750-.doi: 10.3969/j.issn.1674-8115.2019.07.010

• 论著·临床研究 • 上一篇    下一篇

AngioJet血栓抽吸术后髂股静脉支架植入对急性下肢深静脉血栓形成的疗效

杨心蕊，刘光，李维敏，刘晓兵，殷敏毅，黄新天，陆信武   

  1. 上海交通大学医学院附属第九人民医院血管外科，上海交通大学血管病诊治中心，上海 200011
  • 出版日期:2019-07-28 发布日期:2019-08-26
  • 通讯作者: 刘光，电子信箱：angioplasty@163.com。
  • 作者简介:杨心蕊（1988—），女，主治医师，博士；电子信箱： cinder_13@126.com。
  • 基金资助:
    国家自然科学基金（81700432）；上海市卫生与计划生育委员会研究项目（201640078）；上海市第九人民医院临床研究助力计划（JYLJ019）

Therapeutic effect of iliofemoral stenting after AngioJet rheolytic thrombectomy on acute deep vein thrombosis

YANG Xin-rui, LIU Guang, LI Wei-min, LIU Xiao-bing, YIN Min-yi, HUANG Xin-tian, LU Xin-wu   

  1. Department of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; Vascular Center of Shanghai Jiao Tong University, Shanghai 200011, China
  • Online:2019-07-28 Published:2019-08-26
  • Supported by:
    National Natural Science Foundation of China, 81700432; Research Project of Health and Family Planning Commission of Shanghai, 201640078; Clinical Research Program of Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine, JYLJ019

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摘要： 目的 ·分析急性髂股静脉血栓（ deep vein thrombosis，DVT）AngioJet吸栓治疗后行静脉支架植入术的临床疗效。方法 ·回顾性分析 2015年 1月到 2016年 12月上海交通大学医学院附属第九人民医院血管外科因髂股静脉 DVT行 AngioJet吸栓治疗后接受髂股静脉支架植入术的患者，分析技术成功率、 1年通畅率及血栓后综合征（ post thrombotic syndrome，PTS）发生率，并比较吸栓术后直接支架植入术和吸栓后分期支架植入术的疗效。结果 ·共纳入 97例患者，其中直接支架植入组 50例，分期支架植入组 47例。溶栓吸栓治疗后植入支架的技术成功率为 100%，无围手术期严重并发症发生。即时临床缓解率前者为 92.0%，明显高于后者（ 68.1%， P0.000）。12个月随访直接支架植入组通畅率为 93.6%，分期支架植入组为 97.8%，2组差异无统计学意义（ P0.323）。Villalta评分直接支架组高于分期支架组（ 4.21±2.37 vs 2.11±1.82，P0.000）。结论 ·髂股静脉支架植入对于 DVT后髂股静脉压迫 /狭窄病变是一种有效的治疗手段，而支架植入的时机需根据患者基础情况和病变情况决定。

关键词: 下肢深静脉血栓形成, 血栓抽吸术, 静脉支架植入术

Abstract:

Objective · To evaluate the outcomes of patients with acute proximal deep vein thrombosis (DVT) and iliofemoral stenosis who underwent stenting after AngioJet rheolytic thrombectomy. Methods · A retrospective analysis was conducted on the patients who received iliofemoral vein stent implantation after the treatment of iliofemoral vein DVT with AngioJet thrombectomy January 2015 to December 2016 in the Vascular Surgery Department of Shanghai Ninth Peoples Hospital, Shanghai Jiao Tong University School of Medicine. The outcomes included technical success rate, patency rate at 1 year and incidence rate of post thrombotic syndrome (PTS). The effect of direct stenting after AngioJet rheolytic thrombectomy was compared with that of staged stenting. Results · A total of 97 patients were enrolled and divided into direct stenting group (n50) and staged stenting group (n47). The technical success rates were 100% in both groups, and there was no 30-day mortality and serious complication. Immediate clinical improvement in direct group was significantly higher than that in staged group (92.0% vs 68.1%, P0.000). The primary patency rates at 1 year were 93.6% in the direct group and 97.8% in the staged group (P0.323). The Villalta scores in the direct group were significantly higher than those in the staged group (4.21±2.37 vs 2.11±1.82, P0.000). Conclusion · Both direct and staged stenting are effective treatment modalities for patients with acute proximal DVT. The decision of the stenting timing should be based on individual case.

Key words: deep vein thrombosis, rheolytic thrombectomy, venous stenting

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