下肢深静脉血栓形成的综合治疗
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徐周纬E-mail:jinanyun2008@yahoo.com.cn

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The combined therapy of lower extremity deep vein thrombosis
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    摘要:

    目的:探讨下肢深静脉血栓形成的有效治疗方法。
    方法:回顾性分析近5年(2004—2009年)诊疗的411例下肢深静脉血栓形成患者的临床资料;其中8例有明显溶栓、抗凝禁忌证仅予以外敷消肿对症处理,采用常规的溶栓、抗凝、祛聚综合治疗391例,行Fograty导管取栓及综合治疗12例,置入永久性下腔静脉滤器21例。
    结果:382例患者临床症状和体征有明显改善,28例患者无明显疗效或出现并发症,1例患者死亡。184例(44.8%)随诊4~62个月,平均20个月;其中痊愈32例(17.4%),显效107例(58.2%),有效42例(22.8%),无效3例(1.6%)。
    结论:溶栓、抗凝、祛聚综合治疗安全有效;早期手术取栓可明显改善患者预后;下腔静脉滤器置入能有效预防肺动脉栓塞。

    Abstract:

    Objective:To explore the effective methods for therapy of deep vein thrombosis of lower extremity(DVT).
    Methods:We conducted a retrospective analysis of 411 patients with DVT  treated in our hospital from 2004 to 2009.In 8 cases with significant contraindications for thrombolysis and anticoagulation, only symptomatic local treatment for swelling was used. Combined therapy including thrombolysis,anticoagulation,and anti-platelet adhesion therapy was used in 391 cases, and combined therapy and thrombectomy with Fogarty catheter was used in 12 cases. Permanent implantation of inferior vena cava filter(IVCF)was done in 21 cases.
    Results:The changes in clinical signs and symptoms were satisfactory in 382 cases,28 cases had no significant effect from therapy or had complications,and 1 case died.A total of 184(44.8%)cases were follow-up for 4-62 months(average 20 months),the results showed that 32 cases were excellent(17.4%),107 good(58.2%), 42(22.8%) mild improment, and 3 no changes(1.6%).
    Conclusions: Combined therapy with thrombolysis,anticoagulation,and anti-platelet adhesion therapy is effective and safe  for treatment of DVT. Early thrombectomy could improve patients′ prognosis remarkably,and IVCF is an effective measure to prevent pulmonary embolism.

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万圣云, 徐周纬, 丁洋, 潘升权, 张同方.下肢深静脉血栓形成的综合治疗[J].中国普通外科杂志,2009,18(12):1255-1258.
DOI:10.7659/j. issn.1005-6947.2009.12.007

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  • 收稿日期:2009-07-27
  • 最后修改日期:2009-11-07
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  • 在线发布日期: 2009-12-15