• 1.新疆醫(yī)科大學(xué)第五附屬醫(yī)院血管外科(新疆烏魯木齊 830000);;
  • 2.新疆維吾爾自治區(qū)中醫(yī)院血管外科(新疆烏魯木齊 830000);

目的評(píng)價(jià)手術(shù)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(yī)科大學(xué)兩所附屬醫(yī)院住院的下肢深靜脈血栓患者86例，根據(jù)治療方式分為溶栓組與手術(shù)組，溶栓組74例，手術(shù)組12例。手術(shù)組運(yùn)用Fogarty 導(dǎo)管取栓加溶栓; 溶栓組運(yùn)用藥物治療(尿激酶或降纖酶)。結(jié)果出院時(shí)手術(shù)組治愈8例，好轉(zhuǎn)4例，沒有無效病例; 溶栓組治愈15例，好轉(zhuǎn)50例，無效9例。隨訪3～100個(gè)月，平均27個(gè)月。手術(shù)組瓣膜功能正常者6例，溶栓組有9例。手術(shù)組的急性期緩解率、遠(yuǎn)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(shù)組血栓后綜合征發(fā)生率明顯低于溶栓組(P lt;0.05)。結(jié)論早期手術(shù)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(shù)與溶栓治療效果的比較. 中國(guó)普外基礎(chǔ)與臨床雜志, 2011, 18(12): 1309-1313. doi: 復(fù)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(qiáng)， 魏松洋， 楊瑞麗， 等． 下肢深靜脈血栓形成的治療經(jīng)驗(yàn) [J]． 中國(guó)普外基礎(chǔ)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(guó)防醫(yī)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(shí)德， 趙渝．下肢慢性靜脈功能不全治療的再認(rèn)識(shí) [J]. 中國(guó)普外基礎(chǔ)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(jì)蔚． 中西醫(yī)結(jié)合治療下肢深靜脈血栓形成的Meta分析 [J]． 循證醫(yī)學(xué), 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(yán)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(shí)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. 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. 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. 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. 4. 馬志強(qiáng)， 魏松洋， 楊瑞麗， 等． 下肢深靜脈血栓形成的治療經(jīng)驗(yàn) [J]． 中國(guó)普外基礎(chǔ)與臨床雜志， 2011， 18(2): 202203．.
  5. 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. 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. 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. 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(guó)防醫(yī)藥， 2010， 10(10): 10801081．.
  9. 9. HachWunderle V. Treatment of deep vein thrombosis in the leg and pelvis [J]. Med Monatsschr Pharm, 2009, 32(1): 714．.
  10. 10. 時(shí)德， 趙渝．下肢慢性靜脈功能不全治療的再認(rèn)識(shí) [J]. 中國(guó)普外基礎(chǔ)與臨床雜志， 2009， 16(6): 421424．.
  11. 11. Wicky ST. Acute deep vein thrombosis and thrombolysis [J]. Tech Vasc Interv Radiol, 2009, 12(2): 148153.
  12. 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. 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. 14. Geersing GJ, Janssen K, Oudega R, et al. Deep venous thrombosis [J]. Br J Gen Pract, 2011, 61(583): 141147.
  15. 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. 16. 呂磊, 張紀(jì)蔚． 中西醫(yī)結(jié)合治療下肢深靜脈血栓形成的Meta分析 [J]． 循證醫(yī)學(xué), 2008, 8(2): 9196．.
  17. 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. 18. 嚴(yán)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(shí)踐, 2010, 15(3): 321323．.
  19. 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.