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 (1): 102-.doi: 10.3969/j.issn.1674-8115.2019.01.020

• 短篇论著 • 上一篇    下一篇

对侧股静脉入路经皮机械吸栓结合导管接触溶栓治疗急性下肢深静脉血栓形成的效果

卢化祥，黄家麒，黄晟，杨广林，刘晓兵，刘光   

  1. 上海交通大学医学院附属第九人民医院血管外科 ,上海交通大学医学院血管病诊治中心，上海 200011
  • 出版日期:2019-01-28 发布日期:2019-02-27
  • 通讯作者: 刘光，电子信箱：angioplasty@163.com。
  • 作者简介:卢化祥（1989—），男，住院医师，硕士；电子信箱：luhuaxiang2006@126.com。
  • 基金资助:
    国家自然科学基金（81700432）

Percutaneous mechanical thrombectomy combined with catheter-directed thrombolysis in the treatment of deep venous thrombosis of lower extremity via contralateral femoral vein approach

LU Hua-xiang, HUANG Jia-qi, HUANG Sheng, YANG Guang-lin, LIU Xiao-bing, LIU Guang   

  1. Department of Vascular Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine; The Vascular Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Online:2019-01-28 Published:2019-02-27
  • Supported by:
    National Natural Science Foundation of China, 81700432

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摘要： 目的 ·分析经对侧股静脉入路行经皮机械吸栓（ percutaneous mechanical thrombectomy, PMT）结合导管接触溶栓（ catheter-directed thrombolysis，CDT）治疗全肢型急性下肢深静脉血栓形成（ deep venous thrombosis，DVT）的早期临床效果。方法 ·回顾性分析从 2016年 9月至 2017年 8月接受 AngioJet血栓抽吸 + CDT治疗的 45例患者的技术成功率、不同静脉段的血栓溶解程度及治疗过程中并发症的发生情况。结果 ·技术成功率为 100%。其中， 86.7%的患者下肢静脉血栓（ lower extremity thrombosis，LET）Ⅰ段（小腿静脉）完全溶解， 82.2%的患者 LET Ⅱ段（股腘静脉）完全溶解， 71.1%的患者 LET Ⅲ段（髂股总静脉）完全溶解。无严重并发症发生。结论 ·对急性下肢 DVT采用 PMT+CDT是可行的、安全的、有效的。

关键词: 下肢深静脉血栓形成, 经皮机械吸栓, 导管接触溶栓

Abstract:

Objective · To analyze the early clinical effects of acute deep venous thrombosis (DVT) of the lower extremities through a contralateral femoral vein approachpercutaneous mechanical thrombectomy (PMT) combined with catheter-directed thrombolysis (CDT) therapy. Methods · A retrospective analysis about 45 patients (September 2016 to August 2017) was conducted to analyze the success rate of the technique, the degree of thrombolysis in different venous segments, and the incidence of complications during the treatment of PMT+CDT. Results · Technique successful rate was 100%. 86.7% of lower extremity thrombosis (LET) Ⅰ segments (calf veins), 82.2% of LET Ⅱ segments (femoral and popliteal veins) and 71.1% of LET Ⅲ segments (common iliac and femoral veins) were completely dissolved. No serious complications occurred. Conclusion · It is feasible, safe and effective to PMT+CDT in acute DVT.

Key words: deep venous thrombosis of lower extremity, percutaneous mechanical thrombectomy, catheter-directed thrombolysis

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