Wang Wenli, Wu Yanfang, Fang Tao, Xu Dunyuan
Vascular surgery, Yantaishan Hospital, Yantai264001, China.
No. 91 Jiefang Road, Zhifu District, Yantai264001, China.
Open Med (Wars). 2017 Jun 3;12:177-183. doi: 10.1515/med-2017-0026. eCollection 2017.
This study was a retrospective analysis of the efficacy of thrombectomy plus local catheter-directed thrombolysis (CDT) for the treatment of lower extremity deep venous thrombosis (LDVT). The experimental group underwent thrombectomy plus LCDT, whereas the control group underwent thrombectomy plus systemic thrombolysis via the dorsalis pedis vein. Venography and vascular color Doppler ultrasound were performed 7 days after surgery and at follow-up. The differences in the thigh and calf circumferences of normal and affected limbs were compared between groups. The venous patency score and venous patency rate were used for outcome evaluation. Compared with the control group, the experimental group showed a lower venous patency score and higher venous patency rate after treatment (P<0.05). Thirty patients were followed for 3 to 6 months, and according to the last evaluation, the differences in thigh and calf circumference between the normal and affected limbs remained lower in the experimental group than in the control group (P<0.05). Moreover, the venous patency score was lower, and the venous patency rate was higher in the experimental group than in the control group (P<0.05).
Thrombectomy plus CDT yields a higher venous patency rate and lower recurrence rate than pure thrombectomy for the treatment of LDVT.
本研究是一项关于血栓切除术联合局部导管定向溶栓术（CDT）治疗下肢深静脉血栓形成（LDVT）疗效的回顾性分析。实验组接受血栓切除术联合局部导管定向溶栓术，而对照组接受血栓切除术联合经足背静脉全身溶栓术。术后7天及随访时进行静脉造影和血管彩色多普勒超声检查。比较两组正常肢体与患侧肢体大腿和小腿周径的差异。采用静脉通畅评分和静脉通畅率进行疗效评估。与对照组相比，实验组治疗后静脉通畅评分更低，静脉通畅率更高（P<0.05）。对30例患者进行了3至6个月的随访，根据最后一次评估，实验组正常肢体与患侧肢体之间大腿和小腿周径的差异仍低于对照组（P<0.05）。此外，实验组的静脉通畅评分更低，静脉通畅率更高（P<0.05）。
对于LDVT的治疗，血栓切除术联合CDT比单纯血栓切除术具有更高的静脉通畅率和更低的复发率。
