置管溶栓与药物机械溶栓对急性下肢深静脉血栓的临床疗效对比

摘要 目的：对比分析置管溶栓（CDT）与药物机械溶栓（PMT）对急性下肢深静脉血栓（DVT）的安全性与有效性。方法：回顾性分析2018年1月至2021年12月在重庆医科大学附属巴南医院的98例单侧DVT患者临床资料，依据不同的治疗方式分为药物机械溶栓组（PMT组）48例和置管溶栓组（CDT组）50例，对比分析两组患者的围手术期指标、治疗后患侧大腿消肿率和小腿消肿率、血栓溶解率、并发症发生率及术后1年的PTS发生率。结果：PMT组患者的尿激酶使用量及住院时间较CDT组显著缩短，差异具有统计学意义（P<0.05），但术中出血较CDT组显著增加，差异具有统计学意义（P<0.05），PMT组患者的患肢消肿率和血栓溶解率显著高于CDT组，差异具有统计学意义（P<0.05），两组患者的并发症发生率及术后1年的深静脉血栓形成后遗症发生（PTS）率无显著统计学差异（P>0.05）。结论：PMT比CDT具有更好的患肢消肿率及血栓溶解率，且PMT治疗能显著缩短住院时间及减少尿激酶用量，但两者的围手术期并发症发生率及术后1年PTS发生率无显著差异。

Comparison of Clinical Efficacy between Catheter-directed Thrombolysis and Pharmacomechanical Thrombolysis in the Treatment of Acute Deep Venous Thrombosis of Lower Extremities

ABSTRACT Objective: To compare the safety and efficacy of catheter-directed thrombolysis (CDT) and pharmacomechanical thrombolysis (PMT) in the treatment of acute deep venous thrombosis of lower extremities (DVT). Methods: The clinical data of 98 patients with unilateral DVT in Department of Vascular Surgery Banan Hospital affiliated to Chongqing Medical University from January 2018 to December 2021 were retrospectively analyzed. According to different therapeutic modalities, the patients were divided into PMT group(n=48) and CDT group(n=50). The perioperative indicators, the swelling reduction rates of affected thigh and calf, the thrombus clearance rate, the perioperative complications rate and the incidence of PTS in one year after operation were compared and analyzed. Results: The dosage of urokinase and length of hospital stay in PMT group were significantly fewer than CDT group(P<0.05), but the mean blood loss was significantly more than that in CDT group(P<0.05). The swelling elimination rate and thrombus clearance rate of affected limbs in PMT group were significantly better than that of CDT group(P<0.05). There was no significant difference between these two groups on the incidence of perioperative complications and PTS in one year after operation (P>0.05). Conclusion: PMT possesses a higher thrombus clearance rate than CDT, PMT can significantly shorten the length of hospital stay and reduce the dosage of urokinase, but the incidence of perioperative complications and PTS in one year after operation are similar between these two groups.