Abstract:【Objective】To explore the efficacy and safety of pre dilation of small balloons before catheter thrombolysis in the treatment of acute iliofemoral vein thrombosis patients.【Methods】A total of 116 patients with acute iliofemoral vein thrombosis admitted to our hospital from January 2018 to December 2021 were selected as the study subjects. According to the intervention method, they were divided into small balloon dilation combined with catheter thrombolysis treatment (observation group,n=53) and direct catheter thrombolysis treatment (control group, n=63). Comparison was made between two groups of patients before treatment and one week after treatment, including the circumference difference between the healthy and affected sides, venous patency score, venous patency rate, prothrombin time (PT), fibrinogen (FIB) levels, activated partial enzyme thrombin time (APTT), thrombin time (TT), and white blood cell count (WBC) D-dimer (D-D) was used to record the incidence of bleeding, thrombolysis time, dosage of urokinase, and length of hospital stay in two groups of patients.【Results】After treatment, the difference in thigh circumference and calf circumference between the two groups of patients was lower than before treatment, and the observation group was lower than the control group, with statistical significance (P<0.05). After treatment, the deep vein patency scores of both groups of patients were lower than before treatment, and the observation group was lower than the control group (P<0.05); The deep vein patency rate and bleeding incidence rate in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). After treatment, two groups of patients TT The levels of APTT and PT were higher than before treatment, and the observation group was higher than the control group. The FIB levels in both groups were significantly lower than before treatment, and the observation group was lower than the control group (P<0.05). After treatment, the WBC and D-D levels in the observation group were lower than before treatment, and the observation group was lower than the control group (P<0.05). The thrombolysis time, urokinase dosage, and hospital stay in the observation group were all lower than those in the control group, and the differences were statistically significant (P<0.05).【Conclusion】The use of balloon pre dilation before catheter thrombolysis for the treatment of acute iliofemoral vein thrombosis can improve treatment efficacy, have high safety, and have advantages such as high venous patency rate, low dosage of thrombolytic drugs, short thrombolysis time, and low incidence of bleeding.
邱书森. 导管溶栓前小球囊预扩张治疗急性髂股静脉血栓患者的临床及安全性[J]. 医学临床研究, 2024, 41(5): 645-648.
QIU Shusen. Effect and Safety of Small Balloon Pre-Dilation before Catheter Thrombolysis in the Treatment of Acute Iliofemoral Vein Thrombosis Patients. JOURNAL OF CLINICAL RESEARCH, 2024, 41(5): 645-648.
[1] RODOPLU O, YILDIZ C E, OZTAS D M, et al. The efficacy of rotational pharmaco-mechanical thrombectomy in patients with acute iliofemoral deep vein thrombosis: Is the standard treatment of deep vein thrombosis changing?[J].Phlebology,2021,36(2):119-126. [2] 姚鑫,张秀军,陆伟,等. 髂静脉压迫合并急性髂股静脉血栓临床治疗方法研究进展[J].中国中西医结合外科杂志,2020,26(6):1209-1211. [3] GOLDHABER S Z, MAGNUSON E A, CHINNAKONDEPALLI K M, et al. Catheter-directed thrombolysis for deep vein thrombosis: 2021 update[J].Vasc Med,2021,26(6):662-669. [4] FLETCHER S E, JASUJA S, LAWLER L P, et al. Catheter directed thrombolysis and mechanical intervention in deep venous thrombosis: What is the status after the attract trial?[J].Postgrad Med,2021,133(1):42-50. [5] 侯玉芬,刘政.下肢深静脉血栓形成诊断及疗效标准(2015年修订稿)[J].中国中西医结合外科杂志,2016,22(5):520-521. [6] 唐莉鸿,张爱华,袁洪志. 球囊扩张辅助CDT治疗产后下肢DVT的临床研究[J].西南国防医药,2016,26(6):618-621. [7] 牛帅,马百涛,张锐,等. 急性髂股静脉血栓治疗策略的研究进展[J].中华外科杂志,2021,59(9):796-800. [8] BOWDEN S, VANASSELDONK B, EISENBERG N, et al. Ten-year trends in iliofemoral deep vein thrombosis treatment and referral pathways[J].Vascular,2021,29(5):751-761. [9] JIANG C L, ZHAO Y, WANG X H, et al. Midterm outcome of pharmacomechanical catheter-directed thrombolysis combined with stenting for treatment of iliac vein compression syndrome with acute iliofemoral deep venous thrombosis[J].J Vasc Surg Venous Lymphat Disord,2020,8(1):24-30. [10] 蒋俊,李俊杰,柏丈勇,等. 导管溶栓联合药涂球囊扩张术治疗股浅动脉支架再狭窄的临床观察[J].实用放射学杂志,2022,38(7):1166-1170. [11] 李善凯,胡效坤. 导管直接溶栓减容在下肢动脉TASCⅡC、D型治疗中的应用价值[J].实用放射学杂志,2022,38(6):991-993. [12] 金翻亮,任补元,冰峰,等. 导管接触性溶栓同期球囊扩张+支架治疗血栓性髂静脉压迫综合征的疗效[J]. 现代生物医学进展,2021,21(24):4709-4712. [13] 龚心军,李昌剑,车艾青. 丹参化瘀汤联合导管接触溶栓治疗急性期下肢深静脉血栓形成的临床观察[J].中国中医急症,2022,31(5):865-868. [14] 刘军,林瑞敏,陈占,等. 尿激酶联合导管溶栓治疗急性下肢DVT疗效及对相关凝血指标的影响[J].中华普外科手术学杂志(电子版),2018,12(5):396-399. [15] LIU Q, CHEN W, WANG Y L, et al. A new method of monitoring catheter-directed thrombolysis for deep venous thrombosis-application of D-dimer and fibrinogen testing[J].Phlebology,2022,37(3):216-222.