下肢深靜脈血栓手術與溶栓治療效果的比較_《中國普外基礎與臨床雜志》

作者：

 邵新宏 ¹ , 包文 ²

1.新疆醫科大學第五附屬醫院血管外科(新疆烏魯木齊 830000);;
2.新疆維吾爾自治區中醫院血管外科(新疆烏魯木齊 830000);

關鍵詞：

深靜脈血栓溶栓取栓

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目的評價手術與溶栓治療下肢深靜脈血栓的療效。方法回顧性收集新疆醫科大學兩所附屬醫院住院的下肢深靜脈血栓患者86例，根據治療方式分為溶栓組與手術組，溶栓組74例，手術組12例。手術組運用Fogarty 導管取栓加溶栓; 溶栓組運用藥物治療(尿激酶或降纖酶)。結果出院時手術組治愈8例，好轉4例，沒有無效病例; 溶栓組治愈15例，好轉50例，無效9例。隨訪3～100個月，平均27個月。手術組瓣膜功能正常者6例，溶栓組有9例。手術組的急性期緩解率、遠期通暢率、瓣膜功能正常率均明顯高于溶栓組(P lt;0.05)，且手術組血栓后綜合征發生率明顯低于溶栓組(P lt;0.05)。結論早期手術能夠保持深靜脈通暢及瓣膜的完整性，能夠減少深靜脈血栓后綜合征，早期溶栓僅能減輕癥狀，但不能減少瓣膜的損害。

引用本文： 邵新宏,包文. 下肢深靜脈血栓手術與溶栓治療效果的比較. 中國普外基礎與臨床雜志, 2011, 18(12): 1309-1313. doi: 復制

1.	Niranjan A, Agarwal N, Agarwal T, et al. Deep vein thrombosis: review and update [J]. J Indian Med Assoc, 2010, 108(4): 248251.
2.	Klein SJ, Gasparis AP, Virvilis D, et al. Prospective determination of candidates for thrombolysis in patients with acute proximal deep vein thrombosis [J]. J Vasc Surg, 2010, 51(4): 908912.
3.	Rabens C, Goodemote P, Jamieson B. Clinical inquiries: what’s the best way to manage upper extremity venous thrombosis? [J]. J Fam Pract, 2010, 59(8): 465466.
4.	馬志強，魏松洋，楊瑞麗，等．下肢深靜脈血栓形成的治療經驗 [J]．中國普外基礎與臨床雜志， 2011， 18(2): 202203．.
5.	Liu F, Lü P, Jin B. Catheterdirected thrombolysis for acute iliofemoral deep venous thrombosis [J]. J Vasc Surg, 2011, 25(5): 707715.
6.	Rahman A, Colak MC, Ustünel L, et al. A comparison of different treatment managements in patients with acute deep vein thrombosis by the effects on enhancing venous outflow in the lower limb [J]. Med Sci Monit, 2009, 15(11): CR588CR593.
7.	Pollack CV Jr. Advanced management of acute iliofemoral deep venous thrombosis: emergency department and beyond [J]. Ann Emerg Med, 2011, 57(6): 590599.
8.	蘇紅斌，周興立，郭曙光，等．急性DVT股靜脈取栓治療32例 [J]．西南國防醫藥， 2010， 10(10): 10801081．.
9.	HachWunderle V. Treatment of deep vein thrombosis in the leg and pelvis [J]. Med Monatsschr Pharm, 2009, 32(1): 714．.
10.	時德，趙渝．下肢慢性靜脈功能不全治療的再認識 [J]. 中國普外基礎與臨床雜志， 2009， 16(6): 421424．.
11.	Wicky ST. Acute deep vein thrombosis and thrombolysis [J]. Tech Vasc Interv Radiol, 2009, 12(2): 148153.
12.	Labropoulos N, Jen J, Jen H, et al. Recurrent deep vein thrombosis: longterm incidence and natural history [J]. Ann Surg, 2010, 251(4): 749753.
13.	Parisi R, Visonà A, Camporese G, et al. Isolated distal deep vein thrombosis: efficacy and safety of a protocol of treatment. Treatment of Isolated Calf Thrombosis (TICT) Study [J]. Int Angiol, 2009, 28(1): 6872.
14.	Geersing GJ, Janssen K, Oudega R, et al. Deep venous thrombosis [J]. Br J Gen Pract, 2011, 61(583): 141147.
15.	Romera A, Cairols MA, VilaColl R, et al. A randomised openlabel trial comparing longterm subcutaneous lowmolecularweight heparin compared with oralanticoagulant therapy in the treatment of deep venous thrombosis [J]. Eur J Vasc Endovasc Surg, 2009, 37(3): 349356.
16.	呂磊, 張紀蔚．中西醫結合治療下肢深靜脈血栓形成的Meta分析 [J]．循證醫學, 2008, 8(2): 9196．.
17.	Sharifi M, Mehdipour M, Bay C, et al. Endovenous therapy for deep venous thrombosis: the TORPEDO trial [J]. Catheter Cardiovasc Interv, 2010, 76(3): 316325.
18.	嚴赟琦, 張皓. 下肢深靜脈血栓形成綜合征的診斷及治療 [J]．外科理論與實踐, 2010, 15(3): 321323．.
19.	Gnger KH, Nachbur BH, Ris HB, et al. Surgical thrombectomy versus conservative treatment for deep venous thrombosis; functional comparison of longterm results [J]. Eur J Vasc Surg, 1989, 3(6): 529538.

1. Niranjan A, Agarwal N, Agarwal T, et al. Deep vein thrombosis: review and update [J]. J Indian Med Assoc, 2010, 108(4): 248251.
2. Klein SJ, Gasparis AP, Virvilis D, et al. Prospective determination of candidates for thrombolysis in patients with acute proximal deep vein thrombosis [J]. J Vasc Surg, 2010, 51(4): 908912.
3. Rabens C, Goodemote P, Jamieson B. Clinical inquiries: what’s the best way to manage upper extremity venous thrombosis? [J]. J Fam Pract, 2010, 59(8): 465466.
4. 馬志強，魏松洋，楊瑞麗，等．下肢深靜脈血栓形成的治療經驗 [J]．中國普外基礎與臨床雜志， 2011， 18(2): 202203．.
5. Liu F, Lü P, Jin B. Catheterdirected thrombolysis for acute iliofemoral deep venous thrombosis [J]. J Vasc Surg, 2011, 25(5): 707715.
6. Rahman A, Colak MC, Ustünel L, et al. A comparison of different treatment managements in patients with acute deep vein thrombosis by the effects on enhancing venous outflow in the lower limb [J]. Med Sci Monit, 2009, 15(11): CR588CR593.
7. Pollack CV Jr. Advanced management of acute iliofemoral deep venous thrombosis: emergency department and beyond [J]. Ann Emerg Med, 2011, 57(6): 590599.
8. 蘇紅斌，周興立，郭曙光，等．急性DVT股靜脈取栓治療32例 [J]．西南國防醫藥， 2010， 10(10): 10801081．.
9. HachWunderle V. Treatment of deep vein thrombosis in the leg and pelvis [J]. Med Monatsschr Pharm, 2009, 32(1): 714．.
10. 時德，趙渝．下肢慢性靜脈功能不全治療的再認識 [J]. 中國普外基礎與臨床雜志， 2009， 16(6): 421424．.
11. Wicky ST. Acute deep vein thrombosis and thrombolysis [J]. Tech Vasc Interv Radiol, 2009, 12(2): 148153.
12. Labropoulos N, Jen J, Jen H, et al. Recurrent deep vein thrombosis: longterm incidence and natural history [J]. Ann Surg, 2010, 251(4): 749753.
13. Parisi R, Visonà A, Camporese G, et al. Isolated distal deep vein thrombosis: efficacy and safety of a protocol of treatment. Treatment of Isolated Calf Thrombosis (TICT) Study [J]. Int Angiol, 2009, 28(1): 6872.
14. Geersing GJ, Janssen K, Oudega R, et al. Deep venous thrombosis [J]. Br J Gen Pract, 2011, 61(583): 141147.
15. Romera A, Cairols MA, VilaColl R, et al. A randomised openlabel trial comparing longterm subcutaneous lowmolecularweight heparin compared with oralanticoagulant therapy in the treatment of deep venous thrombosis [J]. Eur J Vasc Endovasc Surg, 2009, 37(3): 349356.
16. 呂磊, 張紀蔚．中西醫結合治療下肢深靜脈血栓形成的Meta分析 [J]．循證醫學, 2008, 8(2): 9196．.
17. Sharifi M, Mehdipour M, Bay C, et al. Endovenous therapy for deep venous thrombosis: the TORPEDO trial [J]. Catheter Cardiovasc Interv, 2010, 76(3): 316325.
18. 嚴赟琦, 張皓. 下肢深靜脈血栓形成綜合征的診斷及治療 [J]．外科理論與實踐, 2010, 15(3): 321323．.
19. Gnger KH, Nachbur BH, Ris HB, et al. Surgical thrombectomy versus conservative treatment for deep venous thrombosis; functional comparison of longterm results [J]. Eur J Vasc Surg, 1989, 3(6): 529538.

《中國普外基礎與臨床雜志》

下肢深靜脈血栓手術與溶栓治療效果的比較

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《中國普外基礎與臨床雜志》

下肢深靜脈血栓手術與溶栓治療效果的比較

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料