一种监测导管溶栓治疗深静脉血栓的新方法——D-二聚体和纤维蛋白原检测的应用。
A new method of monitoring catheter-directed thrombolysis for deep venous thrombosis-application of D-dimer and fibrinogen testing.
机构信息
Department of Radiology, Eye & ENT Hospital, 12478Fudan University, Shanghai, China.
Department of Interventional Radiology, 12474Shanghai Jiaotong University Affiliated Sixth People's Hospital South Campus, Shanghai, China.
出版信息
Phlebology. 2022 Apr;37(3):216-222. doi: 10.1177/02683555211064026. Epub 2022 Mar 2.
BACKGROUND
Catheter-directed thrombolysis (CDT) is one of the main treatment methods for acute deep venous thrombosis (DVT), which has the characteristics of long treatment time and large dosage of thrombolytic drugs. In the absence of good monitoring methods, problems such as low thrombolytic efficiency and high risk of bleeding are easy to occur.
OBJECTIVE
To evaluate the value of D-dimer (D-D) and fibrinogen (FIB) testing as a thrombolysis-monitoring method during CDT for acute DVT.
METHODS
Twenty patients with acute DVT were divided into group A and group B. During CDT, the D-D and FIB testing every 8 h were used in group A, and the venography and FIB testing every 24 h in group B. The thrombolysis rate, thrombolysis time, urokinase dosage, and X-ray radiation dose were compared.
RESULTS
The thrombolysis rate in group A was significantly higher than that in group B ( < 0.05), but the number of venography and radiation dose were significantly lower than those in group B ( < 0.05).
CONCLUSION
D-D and FIB testing can improve the thrombolysis rate, reduce the risk of bleeding, and decrease the number of angiograms and X-ray radiation dose during CDT.
背景
导管溶栓（CDT）是急性深静脉血栓形成（DVT）的主要治疗方法之一，具有治疗时间长、溶栓药物剂量大的特点。在缺乏良好的监测方法的情况下，容易出现溶栓效率低、出血风险高等问题。
目的
评价 D-二聚体（D-D）和纤维蛋白原（FIB）检测在急性 DVT 患者 CDT 中的溶栓监测价值。
方法
将 20 例急性 DVT 患者分为 A 组和 B 组。A 组在 CDT 期间每 8 h 检测 1 次 D-D 和 FIB，B 组每 24 h 检测 1 次 D-D、FIB 和静脉造影。比较两组溶栓率、溶栓时间、尿激酶用量和 X 射线辐射剂量。
结果
A 组溶栓率明显高于 B 组（ < 0.05），但静脉造影次数和 X 射线辐射剂量明显低于 B 组（ < 0.05）。
结论
D-D 和 FIB 检测可提高 CDT 中的溶栓率，降低出血风险，减少静脉造影次数和 X 射线辐射剂量。
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