Zhu Chengyan, Zhuo Huawei, Qin Yi, Zhang Weiwei, Qiu Junlan, Ran Feng
1 Department of Surgical Ultrasound, The Affiliated Drum Tower Hospital to Medical School of Nanjing University, China.
2 Department of Vascular Surgery, The Affiliated Drum Tower Hospital to Medical School of Nanjing University, China.
Vascular. 2019 Jun;27(3):277-283. doi: 10.1177/1708538118814609. Epub 2018 Nov 20.
To compare the therapeutic effects of ultrasound-guided and non-guided catheter-directed thrombolysis in the treatment of deep venous thrombosis of lower extremity.
From August 2015 to April 2016, 60 patients with lower extremity deep venous thrombosis were randomly divided into two groups ( n = 30 for each) to receive catheter-directed thrombolysis. Group A was treated under the ultrasound guidance, while Group B was treated without guidance.
Catheter-directed thrombolysis was successfully performed by only one intubate in Group A but by 5.9 intubates in Group B. It took 15.4 ± 3.2 min in Group A, significantly less than that in Group B (30.8 ± 6.6 min, p < 0.05). The incidences of hematoma were also remarkably different between the two groups (3.33% vs. 26.67%, p = 0.026). No pseudoaneurysm or arteriovenous fistula was found in Group A, but there were two cases of pseudoaneurysm and two cases of arteriovenous fistula in Group B (both 6.67%, p = 0.492). The circumference differences of the affected limb between before and after thrombolysis were 49.47 ± 2.484 mm in Group A, significantly higher than that in Group B (28.40 ± 2.856 mm, p < 0.001). After treatment, the venous unobstructed improvement rates and deep vein patency rate were both better than those in Group B (77 + 2.603% vs. 57.23 + 1.828% and 80% vs. 46.67%, respectively; p < 0.001). There were only three cases of PTS in Group A (10%, 3/30), but there were 11 cases in Group B (36.67%, 11/30).
Ultrasound-guided catheter-directed thrombolysis has advantages, with improvement of venous patency and decrease of the incidence of PTS.
比较超声引导下与非引导下导管直接溶栓治疗下肢深静脉血栓形成的疗效。
2015年8月至2016年4月，将60例下肢深静脉血栓形成患者随机分为两组（每组n = 30）接受导管直接溶栓治疗。A组在超声引导下治疗，而B组在无引导下治疗。
A组仅通过一次插管成功进行导管直接溶栓，而B组则需要5.9次插管。A组耗时15.4±3.2分钟，明显少于B组（30.8±6.6分钟，p <0.05）。两组血肿发生率也有显著差异（3.33%对26.67%，p = 0.026）。A组未发现假性动脉瘤或动静脉瘘，但B组有2例假性动脉瘤和2例动静脉瘘（均为6.67%，p = 0.492）。A组溶栓前后患侧肢体周径差为49.47±2.484mm，明显高于B组（28.40±2.856mm，p <0.001）。治疗后，静脉通畅改善率和深静脉通畅率均优于B组（分别为77 + 2.603%对57.23 + 1.828%和80%对46.67%；p <0.001）。A组仅3例发生血栓形成后综合征（10%，3/30），而B组有11例（36.67%，11/30）。
超声引导下导管直接溶栓具有优势，可改善静脉通畅并降低血栓形成后综合征的发生率。
