不同溶栓技术治疗急性下肢深静脉血栓形成患者的疗效及对大小腿患健肢周径差血浆D-二聚体 蛋白C 蛋白S水平的影响

doi:10.3969/j.issn.1006-6233.2021.04.015

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Abstract Objective: To investigate the efficacy of different thrombolytic techniques in the treatment of patients with acute deep venous thrombosis (DVT) of lower extremity and the effects on the circumference difference of the affected and healthy the legs and the plasma D-dimer (D-D), protein C (PC) and protein S (PS) levels.Methods: According to the 1:1 matching principle, the clinical data of 128 patients with acute DVT treated in our hospital from June 2017 to June 2020 who were treated with different surgical plans were collected retrospectively. They were divided into group A (n=32, anterograde popliteal vein thrombolysis), group B (n=32, anterograde saphenous vein thrombolysis), group C (n=32, retrograde thrombolysis), and group D (n=32, systemic thrombolysis). The perioperative conditions, the incidence of complications, and the incidence of post-thrombotic syndrome (PTS), the circumference difference of the affected and healthy the legs, the plasma D-D, PC, PS levels, and the hemodynamics of the deep veins of the lower limbs before and 7 days after the operation in the four groups were counted. Results: The thrombolytic time and symptom resolution time of group A were shorter than those of group B, C, and D, and group B and C were shorter than group D. The patency rate of vein was higher than that of group B, C, and D, and group B and C were higher than group D (P<0.05). At 7 days after operation, the circumference difference of the affected and healthy the legs in group A was smaller than that of group B, C, and D, and group B and C were smaller than that of group D (P<0.05). Plasma DD levels in group A were lower than groups B, C, and D at 7 days postoperatively, PC and PS were higher than groups B, C, and D. The plasma D-D levels in groups B and C were lower than those in group D, and PC and PS were higher than those in group D (P<0.05). At 7 days after operation, the blood flow velocity of femoral vein and popliteal vein in group A was greater than that of group B, C, and D, and the blood flow velocity of femoral vein and popliteal vein of group B and C was greater than that of group D (P<0.05). There was no significant difference in the incidence of complications in the four groups and the incidence of PTS at 1 month after operation (P＞0.05). Conclusion: Catheter-directed thrombolysis (CDT) in the treatment of acute DVT is more advantageous than systemic thrombolysis in terms of symptom resolution time, thrombolysis time, venous patency rate, circumference difference of the affected and healthy the legs, hemodynamics of the deep veins of the lower limbs, plasma D-D, PC, and PS levels, among which anterograde thrombolysis of popliteal vein has the best effect.

Key words： Thrombolysis Acute deep vein thrombosis of the lower extremities Circumference difference of the affected and healthy the legs D-dimer Protein C Protein S

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2021.04.015 OR http://www.hbyxzzs.cn/EN/Y2021/V27/I4/592

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