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IR@PKUHSC  > 北京大学第三临床医学院  > 介入血管外科  > 期刊论文
学科主题: 血管外科学
题名:
急性混合型下肢深静脉血栓取栓与溶栓远期疗效分析
其他题名: Long-term result of thrombectomy and thrombolysis for acute mixed deep vein thrombosis of the lower extremity
作者: 栾景源; 董国祥; 赵军
关键词: 静脉血栓形成 ; 血管外科手术 ; 取栓术 ; 溶栓治疗 ; Venous thrombosis ; Vascular surgical procedures ; Thrombectomy ; Thrombolysis
刊名: 中华普通外科杂志
发表日期: 2008
DOI: 10.3760/j.issn:1007-631X.2008.03.010
卷: 23, 期:3, 页:193-196
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 比较手术取栓与系统溶栓对急性混合型下肢深静脉血栓形成(DVT)的远期疗效.方法 回顾分析1991年9月至2005年6月的142例急性混合型DVT病例的临床资料.手术取栓77例,其中合并髂总静脉狭窄或闭塞49例,对于髂总静脉严重狭窄或闭塞者采取不同方法处理.手术后辅以区域性尿激酶溶栓、肝素抗凝治疗.系统溶栓65例,均系统性应用尿激酶、肝素.结果 治疗后2周,手术取栓组双下肢周径差由(4.3±2.2)cm降为(0.6±0.5)cm,系统溶栓组由(3.9±2.5)cm降为(1.6±0.9)cm,差异有统计学意义(t=-8.346,P=0.00).平均随访(49±42)个月,手术取栓组周径差降为(0.5±0.4)cm,系统溶栓组降为(1.4±1.3)cm(t=-5.764,P=0.00);手术取栓组水肿、色素沉着、溃疡等后遗症发生率分别为29.9%、15.6%、0%,低于系统溶栓组的50.8%、84.6%、6.2%(P<0.05).彩超发现,手术取栓组静脉通畅率(89.6%)和瓣膜功能正常率(72.7%),均高于系统溶栓组(分别为30.8%、9.2%)(Z=-8.502,P=0.00).手术取栓组治愈率70.1%,高于系统溶栓组治愈率30.8%(Z=-4.740,P=0.00).手术组死亡率为3.9%,溶栓组无住院死亡率.结论 本组资料显示手术取栓对急性混合型DVT的疗效好于系统溶栓,尤其在保护静脉瓣膜功能方面明显优于系统溶栓;但手术创伤较大、有一定的死亡率. Objective To study the long-term result of thrombectomy and thrombolysis for acute mixed deep vein thrombosis(DVT)of the lower extremity. Methods Clinical data of 142 patients treated for acute mixed DVT from September,1991 to June,2005 were reviewed.There were 77 patients treated by thrombectomy.Among these 77 patients there were 49 patients whose common iliac vein was occluded or stenosis.All the 77 patients received territorial transfusion with urokinase and hepafin after operation.The other 65 cases were treated by systemic thrombolysis with urokinase and heparin. Results Two weeks after thrombectomy or thrombolysis,the circumference difference between bilateral limbs was occlusive from (4.3±2.2)cm to(0.6±0.5)cm in thrombectomy group,and from(3.9±2.5)cm to(1.6±0.9)cmin thrombolysis group(t=-8.346,P=0.000).Patients were followed up for an average of(49±42)months.The circumference difference between bilateral limbs was reduced to(0.5±0.4)cm in thrombectomy group and(1.4±1.3)cm in thrombolysis group respectively(t=-5.764,P=0.000).The sequela morbidity in thrombectomy group was less than that in thrombolysis group(P<0.05).The morbidity of edema,pigmentation,and ulcer was 29.9%,15.6%,0%in thrombectomy group and 50.8%,84.6%,6.2%in thrombolysis group.In thrombectomy group,89.6%veins regained patency and 72.7%valves had normal function compared with that in thrombolysis group 30.8%and 9.2%(Z=-8.502.P=0.000).The cure rate was 70.1%in thrombectomy group and 30.8%in thrombolysis group (Z=-4.740.P=0.000).Mortality rate was 3.9%in thrombectomy group,while there was no inhospital death in thrombolysis group. Conclusions For the treatment of acute mixed DVT.especially in protecting the normal valve function,thrombectomy was significantly superior to that of thrombolysis except for causing some mortality.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/71726
Appears in Collections:北京大学第三临床医学院_介入血管外科_期刊论文

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作者单位: 北京大学第三医院介入血管外科,100083

Recommended Citation:
栾景源,董国祥,赵军. 急性混合型下肢深静脉血栓取栓与溶栓远期疗效分析[J]. 中华普通外科杂志,2008,23(3):193-196.
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