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血管腔内治疗急性下肢深静脉血栓的中期随访结果
发布日期:2017-08-15 11:26:40

Phlebology. 2016 Mar 27. pii: 0268355516640370.
Mid-term outcome of endovascular treatment for acute lower ext-remity deep venous thrombosis.
Jiang K, Li XQ, Sang HF, Qian AM, Rong JJ, Li CL.

Abstract
      To evaluate the benefit of stenting the iliac vein in patients with residual iliac vein stenosis treated with catheter-directed thrombolysis for acute iliofemoral deep venous thrombosis. We carry out this randomized prospective study, patients with a first-time acute lower extremity deep venous thrombosis that had persisted <14 days were treated with catheter-directed thrombolysis. After catheter-directed thrombolysis, patients with >50% residual iliac vein stenosis were randomly divided into two groups: catheter-directed thrombolysis + Stent Group and catheter-directed thrombolysis Alone Group. Patients received urokinase thrombolysis and low-molecular-weight heparin/oral warfarin during the hospitalization period and were administrated oral warfarin after discharge. Cumulative deep vein patency, the Clinical Etiology Anatomic Pathophysiologic classification system, the Venous Clinical Severity Score and the Chronic Venous Insufficiency Questionnaire score were evaluated.
      为了评价支架置入在导管溶栓治疗急性髂股静脉血栓后的残余髂静脉狭窄中的作用,我们进行了前瞻性随机对照实验。选择导管溶栓治疗后残余髂静脉狭窄>50%的急性下肢深静脉血栓患者,随机分为两组:导管溶栓结合支架置入术治疗组、导管溶栓组。利用深静脉累积通畅率分析、CEAP静脉分类系统、临床严重程度评分(venous clinical severity score,VCSS)和生活质量调查表(chronic venous insufficiency questionnaire,CIVIQ)来对比评估两组治疗效果。导管溶栓结合支架置入术治疗组累积通畅率明显高于单独导管溶栓治疗组(通畅率74.07% vs 46.59%),前者CEAP临床分级和临床严重程度评分显著性低于后者,而生活质量调查表评分高于后者。我们的实验结果表明:对比单独使用导管溶栓,支架置入结合导管溶栓治疗急性髂股静脉血栓后的残余髂静脉狭窄,髂静脉通差率更高,中期随访结果也表明患者生活质量明显增加。

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