置管溶栓联合肝素间歇性脉冲抗凝在急性下肢深静脉血栓患者中的应用效果

doi:10.3969/j.issn.1671-7171.2025.08.024

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摘要【目的】探讨置管溶栓联合肝素间歇性脉冲抗凝在急性下肢深静脉血栓中的应用效果。【方法】选择2023年5月至2024年5月本院收治的102例急性下肢深静脉血栓患者,根据随机数字表法分为对照组(常规溶栓治疗)和观察组(24 h持续泵入尿激酶联合肝素间歇性脉冲抗凝治疗),每组51例。比较两组患者临床疗效、肿胀缓解度、静脉通畅度、疼痛程度、实验室指标[活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)、C反应蛋白(CRP)、D-二聚体(D-D)],比较两组不良反应发生率及复发情况。【结果】观察组临床有效率为96.08%(49/51),高于对照组的80.39%(41/51),差异有统计学意义(χ²=6.044,P<0.05)。治疗后,两组肿胀缓解度高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组静脉通畅度、视觉模拟评分法(VAS)评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者APTT长于治疗前,且观察组长于对照组,差异有统计学意义(P<0.05);Fib、D-D、CRP水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组不良反应总发生率比较,差异无统计学意义(P>0.05)。观察组患者术后血栓清除率、1年血管通畅率高于对照组,1年内复发率低于对照组,差异有统计学意义(P<0.05)。【结论】置管溶栓联合肝素间歇性脉冲抗凝在急性下肢深静脉血栓中的应用效果较好,有助于提高静脉通畅率,改善下肢肿胀,降低血栓复发率,具有较好的临床效果。

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	刘志杰

关键词 ：血栓溶解疗法, 下肢, 静脉血栓形成, 急性病, 治疗结果

Abstract：【Objective】To investigate the application effect of catheter-directed thrombolysis combined with intermittent pulsed heparin anticoagulation in acute lower extremity deep vein thrombosis (DVT). 【Methods】 A total of 102 patients with acute lower extremity DVT admitted to our hospital from May 2023 to May 2024 were selected and divided into the control group (receiving conventional thrombolytic therapy) and the observation group (receiving continuous 24-hour pump infusion of urokinase combined with intermittent pulsed heparin irrigation) using a random number table method, with 51 patients in each group. The clinical efficacy, swelling relief degree, venous patency, pain level, laboratory indicators [activated partial thromboplastin time (APTT), fibrinogen (Fib), D-dimer (D-D) detected by chemiluminescence method], incidence of adverse reactions, and recurrence were compared between the two groups. 【Results】The clinical effective rate in the observation group was 96.08% (49/51), which was higher than that in the control group (80.39%, 41/51), with a statistically significant difference (χ²=6.044, P<0.05). After treatment, the swelling relief degree in both groups was higher than that before treatment, and it was higher in the observation group than in the control group (P<0.05). The venous patency and VAS scores in both groups were lower than those before treatment, and they were lower in the observation group than in the control group (P<0.05). After treatment, the APTT in both groups was longer than that before treatment, and it was longer in the observation group than in the control group (P<0.05). The levels of Fib, D-D, and CRP were lower than those before treatment, and they were lower in the observation group than in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). The postoperative thrombus clearance rate and 1-year vascular patency rate in the observation group were higher than those in the control group, while the 1-year recurrence rate was lower than that in the control group, with statistically significant differences (P<0.05). 【Conclusion】Catheter-directed thrombolysis combined with intermittent pulsed heparin anticoagulation demonstrates good application effects in acute lower extremity DVT. It helps improve venous patency, alleviate lower extremity swelling, reduce thrombosis recurrence rate, and shows favorable clinical outcomes.

Key words： Thrombolytic Therapy Lower Extremity Venous Thrombosis Acute Disease Treatment Outcome

收稿日期: 2025-04-21

中图分类号:

R364.15

引用本文:

刘志杰. 置管溶栓联合肝素间歇性脉冲抗凝在急性下肢深静脉血栓患者中的应用效果[J]. 医学临床研究, 2025, 42(8): 1378-1381.
LIU Zhijie. Application Effect of Catheter-Directed Thrombolysis Combined with Intermittent Pulsed Anticoagulation in Patients with Acute Lower Extremity Deep Vein Thrombosis. JOURNAL OF CLINICAL RESEARCH, 2025, 42(8): 1378-1381.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2025.08.024 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2025/V42/I8/1378

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