| 洪磊,沈涛,谢峦,等.不同血栓清除方式治疗下肢深静脉血栓的效果对比[J].中国临床保健杂志,2026,29(2):195-199. |
| 不同血栓清除方式治疗下肢深静脉血栓的效果对比 |
| Comparative analysis of the efficacy of different thrombus removal modalities in the treatment of lower extremity deep vein thrombosis |
| 投稿时间：2026-03-09 |
| DOI：10.3969/J.issn.1672-6790.2026.02.010 |
| 中文关键词: 下肢深静脉血栓 血栓切除术 支架 纤维蛋白溶解药 |
| 英文关键词: Lower extremity deep vein thrombosis Thrombectomy Stent Fibrinolytic agents Fund program:Natural Science Foundation of Anhui Province |
| 基金项目:安徽省自然科学基金项目 |
| 作者 | 单位 | | 洪磊 | 中国科学技术大学附属第一医院安徽省立医院血管外科,合肥 230001 | | 沈涛 | 寿县人民医院血管外科,淮南 232200 | | 谢峦 | 阜阳市第六人民医院血管外科,阜阳 236000 | | 方征东 | 中国科学技术大学附属第一医院安徽省立医院血管外科,合肥 230001 | | 孙小杰 | 中国科学技术大学附属第一医院安徽省立医院血管外科,合肥 230001 | | 胡何节 | 中国科学技术大学附属第一医院安徽省立医院血管外科,合肥 230001 | | 葛新宝 | 中国科学技术大学附属第一医院安徽省立医院血管外科,合肥 230001 | | 程灿 | 中国科学技术大学附属第一医院安徽省立医院血管外科,合肥 230001 | | 沈广辉 | 中国科学技术大学附属第一医院安徽省立医院血管外科,合肥 230001 | | 王晓天 | 中国科学技术大学附属第一医院安徽省立医院血管外科,合肥 230001 |
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| 中文摘要: |
| 目的 探讨单纯抗凝(AC)、导管接触性溶栓(CDT)、机械性血栓清除(PMT)治疗下肢深静脉血栓(DVT)的效果差异与安全性。方法 回顾性分析2022年1月至2025年1月于中国科学技术大学附属第一医院(安徽省立医院)确诊并治疗的90例急性下肢DVT患者的临床资料。根据治疗方案分为AC组(30例)、CDT组(30例)、PMT组(30例)。对比分析三组患者的基线资料、早期疗效(血栓清除率、肢体周径差)及远期疗效(静脉通畅评分、Villalta评分)。结果 三组患者基线资料比较,差异无统计学意义(P>0.05)。在早期血栓清除率及肢体肿胀消退方面,PMT组和CDT组均优于AC组(均P<0.05)。术后12个月随访显示,PMT组远期疗效优于CDT组及AC组,CDT组与AC组差异无统计学意义(P>0.05)。进一步对介入组进行亚组分析,支架组术后12个月的静脉通畅评分及Villalta评分低于非支架组；CDT+支架组术后12个月的静脉通畅评分及Villalta评分低于AC组(P<0.05)。结论 对于急性期下肢DVT,尤其是中央型或混合型DVT,积极的介入治疗(CDT或PMT)联合髂静脉支架植入能更有效地清除血栓、维持远期静脉通畅、降低血栓后综合征发生率。单纯抗凝治疗虽然血栓后综合征发生率高,但对于周围型DVT、高龄、高出血风险或无法接受介入治疗的患者,仍是安全且不可替代的基础治疗。 |
| 英文摘要: |
| Objective To explore the differences in efficacy and safety among anticoagulation (AC),catheter-directed thrombolysis (CDT),and percutaneous mechanical thrombectomy (PMT) in the treatment of deep venous thrombosis (DVT) in the lower extremities.Methods A retrospective analysis was conducted on the clinical data of 90 patients with acute DVT in the lower extremities diagnosed and treated in the First Affiliated Hospital of University of Science and Technology of China from January 2022 to January 2025.Patients were divided into three groups based on their treatment regimens:AC group (n=30),CDT group (n=30),PMT group (n=30).The baseline characteristics,early efficacy (thrombus clearance rate,limb circumference difference),and long-term efficacy (venous patency score,Villalta score) were compared among the three groups.Results There were no significant differences in baseline characteristics among the three groups (P>0.05).In terms of early thrombus clearance rate and limb swelling regression,both the PMT group and the CDT group showed superior to the AC group (both P<0.05).Follow-up at 12 months after surgery showed that the long-term efficacy of the PMT group was superior to that of the CDT group and the AC group,with a no statistically significant difference between the CDT group and the AC group (P>0.05).Subgroup analysis further revealed that the stent group had a lower venous patency score and Villalta score at 12 months compared to the non-stent group;the CDT+stent group had a lower venous patency rate and Villalta score at 12 months compared to the AC group (P<0.05).Conclusions For acute DVT in the lower extremities,especially for central or mixed type DVT,aggressive interventional therapy (CDT or PMT) combined with iliac vein stent implantation can more effectively clear thrombus,maintain long-term venous patency,and reduce the incidence of post-thrombotic syndrome.Although anticoagulation therapy alone has a high incidence of post-thrombotic syndrome,it remains a safe and irreplaceable basic treatment for patients with peripheral DVT,elderly patients,those at high risk of bleeding,or those unable to undergo interventional therapy. |
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