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目的:观察置入下腔静脉滤器联合介入性溶栓治疗在下肢深静脉血栓形成中的疗效。方法:2007年10月～2011年10月我科收治84例下肢深静脉血栓形成患者,其中51例采用下腔静脉滤器联合介入性溶栓,同时常规抗凝治疗为观察组;33例常规抗凝、溶栓治疗为对照组,观察临床变化并进行3～46个月随访。结果:观察组在出院时治疗有效率显著高于对照组(98%vs.58%,P<0.01),随访3个月治疗有效率也高于对照组(98%vs.79%,P<0.01);观察组出血并发症较对照组显著减少(4%vs.27%,P<0.05),静脉血栓综合征的发生率低于对照组(2%vs.15%,P<0.05);观察组在肺动脉栓塞发生率上有显著降低(观察组0%,对照组12%,P<0.01)。结论:置入下腔静脉滤器联合介入性溶栓治疗下肢深静脉血栓效果优于传统溶栓治疗,能有效预防或减少肺栓塞的发生,但应严格掌握下腔静脉滤器的置入指征。
Objective: To observe the effect of inferior vena cava filter combined with interventional thrombolysis in deep venous thrombosis of lower extremity. Methods: From October 2007 to October 2011, 84 patients with deep venous thrombosis of lower extremities were treated in our department. Among them, 51 patients underwent IVF with interventional thrombolysis and conventional anticoagulant therapy for the observation group. 33 patients Coagulation, thrombolytic therapy for the control group, observe the clinical changes and 3 to 46 months follow-up. Results: The effective rate of treatment in the observation group was significantly higher than that of the control group (98% vs. 58%, P <0.01). The effective rate of the observation group was also higher than that of the control group (98% vs 79%, P < 0.01). The bleeding complication in the observation group was significantly lower than that in the control group (4% vs.27%, P <0.05). The incidence of venous thrombosis was lower in the observation group than in the control group (2% vs.15%, P <0.05). The observation group had a significant decrease in the incidence of pulmonary embolism (0% in the observation group and 12% in the control group, P <0.01). CONCLUSIONS: Inferior vena cava filter combined with interventional thrombolysis is superior to traditional thrombolysis in the treatment of lower extremity deep venous thrombosis, which can effectively prevent or reduce the occurrence of pulmonary embolism. However, the indication of inferior vena cava filter should be strictly controlled.