导管接触性溶栓联合静脉溶栓对下肢深静脉血栓形成患者血栓弹力图参数、血栓清除效果及消肿效果的影响

doi:10.3969/j.issn.1671-7171.2026.02.020

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摘要 【目的】 探讨导管接触性溶栓联合静脉溶栓对下肢深静脉血栓形成(DVT)患者血栓弹力图参数、血栓清除效果及消肿效果的影响。【方法】 选取2021年1月至2025年1月本院收治的59例下肢DVT患者,根据随机数字表法将患者分为观察组(n=30)和对照组(n=29)。对照组采用单纯静脉溶栓治疗,观察组采用导管接触性溶栓联合静脉溶栓治疗。比较两组患者的血栓清除率,治疗前后的血栓弹力图参数、消肿效果及静脉通畅情况。【结果】 治疗后,观察组的凝血反应时间(R)、凝血形成时间(K)显著短于对照组,最大振幅(MA)及凝固角(α角)显著高于对照组,差异有统计学意义(P<0.05)。观察组血栓清除率为93.33%(28/30),显著高于对照组的86.21%(25/29),差异有统计学意义(P<0.05)。治疗后,观察组的静脉通畅评分显著低于对照组,大腿周径、小腿周径显著小于对照组,大腿及小腿的消肿率显著高于对照组(P<0.05)。【结论】 导管接触性溶栓联合静脉溶栓治疗下肢DVT,可有效提高血栓清除率,改善患者凝血功能及静脉通畅度,增强消肿效果,且安全性良好,值得临床推广应用。

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	蒋保华
	金磊
	张莎莎

关键词 ：静脉血栓形成, 下肢, 机械溶栓, 血栓溶解疗法, 血栓弹力描记术

Abstract：【Objective】 To explore the effect of catheter-directed thrombolysis (CDT) combined with intravenous thrombolysis (IVT) on thromboelastogram (TEG) parameters, thrombus clearance and detumescence effect in patients with lower extremity deep venous thrombosis (DVT). 【Methods】 A total of 59 patients with lower extremity DVT admitted to our hospital from January 2021 to January 2025 were selected and divided into the observation group (n=30) and the control group (n=29) according to the random number table method. The control group was treated with simple intravenous thrombolysis, while the observation group was treated with catheter-directed thrombolysis combined with intravenous thrombolysis. The thrombus clearance rate, TEG parameters before and after treatment, detumescence effect and venous patency were compared between the two groups. 【Results】 After treatment, the coagulation reaction time (R), coagulation formation time (K) of the observation group were significantly shorter than those of the control group, and the maximum amplitude (MA) and coagulation angle (α angle) were significantly higher than those of the control group, with statistically significant differences (P<0.05). The thrombus clearance rate of the observation group was 93.33% (28/30), which was significantly higher than 86.21% (25/29) of the control group, and the difference was statistically significant (P<0.05). After treatment, the venous patency score of the observation group was significantly lower than that of the control group, the thigh circumference and calf circumference were significantly smaller than those of the control group, and the detumescence rate of the thigh and calf was significantly higher than that of the control group (P<0.05). 【Conclusion】 Catheter-directed thrombolysis combined with intravenous thrombolysis in the treatment of lower extremity DVT can effectively improve the thrombus clearance rate, improve the patient's coagulation function and venous patency, enhance the detumescence effect, and has good safety, which is worthy of clinical promotion and application.

Key words： Venous Thrombosis Lower Extremity Mechanical Thrombolysis Thrombolytic Therapy Thrombelastography

收稿日期: 2025-09-26

中图分类号:

R459.7

引用本文:

蒋保华, 金磊, 张莎莎. 导管接触性溶栓联合静脉溶栓对下肢深静脉血栓形成患者血栓弹力图参数、血栓清除效果及消肿效果的影响[J]. 医学临床研究, 2026, 43(2): 250-253.
JIANG Baohua, JIN Lei, ZHANG Shasha. The Effect of Catheter-Directed Thrombolysis Combined with Intravenous Thrombolysis on Thromboelastogram Parameters, Thrombus Clearance and Detumescence Effect in Patients with Lower Extremity Deep Venous Thrombosis. JOURNAL OF CLINICAL RESEARCH, 2026, 43(2): 250-253.

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http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2026.02.020 或 http://journal07.magtech.org.cn/yxlcyj/CN/Y2026/V43/I2/250

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