背景:急性下肢深静脉血栓形成(LEDVT)是一种常见的血管急症,具有显著的发病风险,包括血栓后综合征(PTS)和肺栓塞。传统的治疗方法,如导管溶栓(CDT)通常会导致不同的成功率和并发症。
目的:探讨经皮机械取栓治疗急性LEDVT的疗效。
方法:对2019年8月至2022年8月期间58例急性LEDVT住院患者进行回顾性分析。将患者分为经皮机械血栓切除术(PMT)组(n=24)和CDT组(n=32)。后续行动,比较两组的安全性和治疗结局.主要观察指标为静脉通畅度评分,血栓清除效果,并发症,住院时间和PTS。
结果:PMT组静脉通畅评分为9.04±1.40,CDT组静脉通畅评分为8.81±1.60,两组的血栓清除率均为100%。术后并发症发生率PMT组为8.33%,CDT组为34.84%,差异有统计学意义(P<0.05)。PMT组平均住院时间为6.54±2.48天,CDT组为8.14±3.56天。PMT组PTS的发生率低于CDT组;然而,差异无统计学意义(P<0.05)。
结论:与CDT相比,通过PMT治疗LEDVT与更好的血栓清除率相关,临床治疗效果和PTS预防功能,但差异无统计学意义。此外,PMT与尿激酶剂量减少有关,缩短住院时间,降低并发症发生率,如感染和小出血。这些结果表明,PMT在LEDVT的治疗中具有显著的有益效果。
BACKGROUND: Acute lower extremity deep venous thrombosis (LEDVT) is a common vascular emergency with significant morbidity risks, including post-thrombotic syndrome (PTS) and pulmonary embolism. Traditional treatments like catheter-directed thrombolysis (CDT) often result in variable success rates and complications.
OBJECTIVE: To investigate the therapeutic efficacy of percutaneous mechanical thrombus removal in acute LEDVT.
METHODS: A retrospective analysis was performed to examine 58 hospitalised patients with acute LEDVT between August 2019 and August 2022. The patients were categorised into the percutaneous mechanical thrombectomy (PMT) group (n = 24) and CDT group (n = 32). The follow-up, safety and treatment outcomes were compared between the two groups. The main observational indexes were venous patency score, thrombus removal effect, complications, hospitalisation duration and PTS.
RESULTS: The venous patency score was 9.04 ± 1.40 in the PMT group and 8.81 ± 1.60 in the CDT group, and the thrombus clearance rate was 100% in both groups. The complication rate was 8.33% in the PMT group and 34.84% in the CDT group, and the difference was statistically significant (P < 0.05). The average hospitalisation duration was 6.54 ± 2.48 days in the PMT group and 8.14 ± 3.56 days in the CDT group. The incidence of PTS was lower in the PMT group than in the CDT group; however, the difference was not statistically significant (P < 0.05).
CONCLUSIONS: Compared with CDT, treatment of LEDVT via PMT was associated with a better thrombus clearance rate, clinical therapeutic effect and PTS prevention function, but the difference was not statistically significant. Moreover, PMT was associated with a reduced urokinase dosage, shortened hospitalisation duration and reduced incidence of complications, such as infections and small haemorrhages. These results indicate that PMT has substantial beneficial effects in the treatment of LEDVT.