文章摘要
王杰克,周文华,刘涛,张金通,张任怡,郑祥坚.下腔静脉滤器植入联合经皮机械性血栓清除术与球囊扩张治疗老年髋骨折合并髂股静脉血栓患者的价值[J].中国临床保健杂志,2024,(1):93-96.
下腔静脉滤器植入联合经皮机械性血栓清除术与球囊扩张治疗老年髋骨折合并髂股静脉血栓患者的价值
Value of inferior vena cava filter implantation combined with PMT and balloon dilation in the treatment of elderly patients with hip fractures complicated with iliofemoral vein thrombosis
投稿时间：2023-10-16  
DOI：10.3969/J.issn.1672-6790.2024.01.019
中文关键词: 髋骨折  静脉血栓栓塞  腔静脉滤器  血管成形术,气囊  老年人
英文关键词: Hip fractures  Venous thromboembolism  Vena cava filters  Angioplasty,balloon  Aged 〖FL
基金项目:
作者单位E-mail
王杰克 乐清市第二人民医院, 骨科,乐清 325608 wowjack@126.com 
周文华 乐清市第二人民医院,介入导管室,乐清 325608  
刘涛 乐清市第二人民医院, 骨科,乐清 325608  
张金通 乐清市第二人民医院, 骨科,乐清 325608  
张任怡 乐清市第二人民医院,介入导管室,乐清 325608  
郑祥坚 温州市中心医院血管外科  
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中文摘要:
      目的 探讨下腔静脉滤器植入联合经皮机械性血栓清除术(PMT)与球囊扩张治疗老年髋骨折合并髂股静脉血栓患者的价值。方法 选取2021年6月至2023年1月在乐清市第二人民医院和温州市中心医院治疗的121例老年髋骨折合并髂股静脉血栓患者,按照随机数字表法分为联合组61例和常规组60例,2组均接受一般抗凝治疗,常规组采用下腔静脉滤器植入联合PMT治疗,联合组在常规组的基础上联合球囊扩张。随访2个月后,对比2组静脉通畅评分、血栓清除率、Villalta评分及血栓后综合征(PTS)发生率、实验室指标[红细胞(RBC)、血红蛋白(Hb)、D-二聚体、纤维蛋白原(FIB)]、并发症发生情况。结果 治疗前常规组与联合组静脉通畅评分差异无统计学意义(P>0.05)；随访2个月后2组静脉通畅评分均下降,且与常规组相比,联合组评分更低(P<0.05)；随访2个月后血栓清除率2组相对比,联合组高于常规组(P<0.05)。随访2个月后联合组Villalta评分低于常规组(P<0.05)；轻、中度PTS总发生率联合组均低于常规组(P<0.05)。治疗前2组凝血指标差异均无统计学意义(P>0.05),2组治疗后血清D-二聚体及FIB水平均降低,且联合组低于常规组(P<0.05)。治疗期间联合组发生出血、血肿、血尿等并发症发生率差异无统计学意义(P>0.05)。结论 下腔静脉滤器植入联合PMT联合球囊扩张可有效清除髋骨折合并髂股静脉血栓患者的静脉血栓,缓解病情,且安全性良好。
英文摘要:
      Objective To explore the value of inferior vena cava filter implantation combined with percutaneous mechanical thrombectomy (PMT) and balloon dilation in the treatment of elderly patients with hip fractures complicated with iliofemoral vein thrombosis.Methods One hundred and twenty-one elderly patients with hip fractures complicated with iliofemoral vein thrombosis who were hospitalized in the Second People′s Hospital of Yueqing City and Wenzhou Central Hospital from June 2021 to January 2023 were randomly divided into combined group (61 cases) and conventional group (60 cases).Both groups received general anticoagulation and compression treatment,and the conventional group was given inferior vena cava filter implantation plus PMT treatment,and the combined group was combined with balloon dilatation on the basis of the conventional group.After 2 months of treatment,the venous patency score,thrombus clearance rate,Villalta score,incidence rate of post-thrombotic syndrome (PTS),laboratory indicators[red blood cell (RBC),hemoglobin (Hb),D-dimer,fibrinogen (FIB)],occurrence of complications were compared between the two groups.Results Before treatment,there was no statistically significant difference in venous patency score between conventional group and combined group (P>0.05).After 2 months of treatment,the venous patency score in both groups was decreased,and the score in combined group was lower compared with that in conventional group (P<0.05).The thrombus clearance rate in combined group after 2 months of treatment was higher than that in conventional group (P<0.05).After 2 months of treatment,the Villalta score was lower in combined group than that in conventional group (P<0.05).The total incidence rate of mild-to-moderate PTS in combined group was lower than that in conventional group (P<0.05).There were no statistically significant differences in blood indicators between the two groups before treatment (P>0.05).Serum D-dimer and FIB levels in the two groups were decreased after treatment,and the levels in combined group were lower than those in conventional group (P<0.05).During treatment,the incidence rates of complications such as hemorrhage,hematoma and hematuria in combined group were lower than those in conventional group,and the total incidence rate was lower than that in conventional group (P>0.05).Conclusions Inferior vena cava filter implantation combined with PMT combined with balloon dilation can effectively remove the venous thrombosis and alleviate the disease condition in patients with hip fractures complicated with iliofemoral vein thrombosis.
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