急性下肢深静脉血栓形成52例诊治体会

目的探讨急性下肢深静脉血栓形成的诊治方法。方法回顾性分析2006年10月至2011年10月间收治52例急性下肢深静脉血栓形成患者的临床资料。结果 52例患者肢体肿胀、疼痛症状均缓解出院。药物治疗52例发生1例有症状肺栓塞,经溶栓抗凝治疗后好转;无其他出血并发症。1例股青肿合并Cockett手术取栓加PTAS,术前置入腔静脉滤器(inferior venacava filter,IVCF),患者恢复满意,足背动脉博动恢复。41例随访1～50个月,平均12.4个月。结论尿激酶辅以低分子肝素钙在下肢DVT中应用是安全、有效的,严格抗凝溶栓可降低PE。IVEF的置入应严格掌握适应证。介入联合手术治疗股青肿合并Cock-ett综合征疗效确切。

Diagnosis and management for 102 cases with acute deep vein thrombosis of lower extremity (a report of 102 cases)

Objective To explore the diagnosis and management of acute deep vein thrombosis(DVT) of lower extremity.Methods From October 2006 to October 2011,The clinical data of 52 patients with DVT were analysed retrospectively.Results All patients were successfully treated by thrombolysis with urokinase.There were no bleeding complications during the treatment for 52cases,but symptomatic PE occurred in 1 cases,and they recovered after thrombolysis and anticoagulation treatment.Surgical treatment 、PTA and sent insertion for 1 patient with Cockett syndrome complicated with phlegmasia cerulean dolens(PCD),inferior vena cava filter(IVCF) was inserted before Surgical treatment.The patient recovered well,and dorsalis pedis artery pulsation was restored.During a mean time of 12.4 months(1month-50months),52cases were followed up.Conclusion Vascular color ultrasounography is the first choice of non-invasive examination.The hsCRP was positively related to the severity of DVT.The regional urokinase infusion therapy and anticoagulation with LMWHS is a safe and effective therapy for the patients with DVT of lower extremity.Strist adherence to the guidelines of anticoagulant and thrombolytic therapy can effectively reduce the incidence of PE in patients.The indications for IVCF placement should be strictly grasped by clinicians.The combined interventional and surgical treatment of Cockett syndrome complicated with PCD is effective.