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药物机械性血栓抽吸术治疗急性深静脉血栓形成患者时追加溶栓治疗的长期结果:一项比较研究

Long-term results of additional thrombolytic therapy in patients with acute deep vein thrombosis treated with pharmacomechanical thromboaspiration: A comparative study.

作者信息

Kavala Ali Aycan, Türkyılmaz Saygın

机构信息

Department of Cardiovascular Surgery, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.

出版信息

Turk Gogus Kalp Damar Cerrahisi Derg. 2018 Sep 16;26(4):579-587. doi: 10.5606/tgkdc.dergisi.2018.15871. eCollection 2018 Oct.

Abstract

BACKGROUND

This study aims to evaluate the clinical and ultrasonographic long-term results of additional thrombolytic therapy to pharmacomechanical thromboaspiration in patients with acute and subacute lower extremity deep vein thrombosis.

METHODS

Medical data of a total of 68 patients ( 41 males, 27 females; mean age 38 years; range, 25 to 56 years) who were admitted to our department with the diagnosis of hyperacute or acute deep vein thrombosis between January 2013 and January 2015 were retrospectively analyzed. The patients were divided into two groups: thrombectomy without thrombolytic therapy (Group 1, n=33) and thrombectomy with thrombolytic therapy (Group 2, n=35). All patients were administered Clinical Symptom Scoring and Doppler ultrasonography at one, six, and 12 months.

RESULTS

Clinical symptom scores were higher in Group 1 at one month (p<0.001), while there was no significant difference between the groups at six months (p=0.102). Group 1 had higher scores at 12 months (p=0.043). The complete patency rates for both groups were similar at one month (p=0.181); however, the rates were higher in Group 2 at six and 12 months (p=0.019 and p=0.002, respectively). There was no significant difference in the complete patency rates between the groups at one and six months (p=0.563 and p=0.064, respectively), while these rates were higher in Group 2 at 12 months (p=0.013). In patients with acute deep vein thrombosis, the complete patency rates were found to be higher in all control Doppler ultrasonography examinations.

CONCLUSION

In the treatment of both hyperacute and acute deep vein thrombosis, the addition of thrombolytic therapy to pharmacomechanical thromboaspiration improves the clinical symptoms and venous patency rates.

摘要

背景

本研究旨在评估在急性和亚急性下肢深静脉血栓形成患者中,在药物机械性血栓抽吸基础上追加溶栓治疗的临床和超声长期结果。

方法

回顾性分析2013年1月至2015年1月间因超急性或急性深静脉血栓形成诊断入院的68例患者(41例男性,27例女性;平均年龄38岁;范围25至56岁)的医疗数据。患者分为两组:未进行溶栓治疗的血栓切除术组(第1组,n = 33)和进行溶栓治疗的血栓切除术组(第2组,n = 35)。所有患者在1个月、6个月和12个月时接受临床症状评分和多普勒超声检查。

结果

第1组在1个月时临床症状评分较高(p < 0.001),而在6个月时两组之间无显著差异(p = 0.102)。第1组在12个月时评分较高(p = 0.043)。两组在1个月时的完全通畅率相似(p = 0.181);然而,第2组在6个月和12个月时的通畅率较高(分别为p = 0.019和p = 0.002)。两组在1个月和6个月时的完全通畅率无显著差异(分别为p = 0.563和p = 0.064),而第2组在12个月时的这些比率较高(p = 0.013)。在急性深静脉血栓形成患者中,在所有对照多普勒超声检查中发现完全通畅率较高。

结论

在超急性和急性深静脉血栓形成的治疗中,在药物机械性血栓抽吸基础上追加溶栓治疗可改善临床症状和静脉通畅率。

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