下肢深静脉血栓致急性肺动脉栓塞的双介入治疗分析(1)
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[摘要] 目的 分析双介入治疗下肢深静脉血栓(DVT)致急性肺动脉栓塞(PE)的疗效与安全性。方法 将本院采取双介入治疗的DVT致急性PE患者根据置入下腔静脉滤器种类分为临时组与永久组，对比两组术后及随访情况。结果 两组术后测得下肢静脉压、SPO2，统计手术成功率及出院前统计住院时间均无明显差异，P > 0.05；术后12个月临时组血栓复发率、手术并发症发生率与口服用药时间均显著低于永久组，P < 0.01；但永久组滤器故障率明显低于临时组，P < 0.05。结论 双介入置入临时下腔静脉滤器近期疗效确切，远期疗效良好，安全可行，是治疗下肢深静脉血栓致急性肺动脉栓塞的良好选择。
[关键词] 下肢深静脉血栓；急性肺动脉栓塞；介入治疗；分析
[中图分类号] R563.5 [文献标识码] A [文章编号] 1674-4721(2012)04(a)-0063-02
Dual intervention analysis of acute pulmonary embolism caused by deep vein thrombosis
ZHANG Pengfei ZHONG Zhixiong LI Bin
Cardiology Department of People's Hospital of Meizhou City in Guangdong Province, Meizhou 514031, China
[Abstract] Objective To analyze the effect and safety of dual intervention of acute pulmonary embolism caused by deep vein thrombosis. Methods Divided acute pulmonary embolism patients caused by taking dual intervention in our hospital into temporary group and permanent group, compared the situation of postoperative and following-up. Results There were no significant differences of measured after venous pressure, SPO2, statistical success rate of surgery and hospital stay before discharge in postoperative treatment, P > 0.05; Thrombosis recurrence rate, incidence of surgical complications and oral medication time of temporary group 12 months after surgery were significantly lower than permanent group, P < 0.01; but filter failure rate of permanent group was significantly lower than temporary group, P < 0.05. Conclusion The short-term effect of dual involvement of temporary inferior vena cava filter placement is effective, the long-term efficacy is good, safe and feasible, is the good choice to treat acute pulmonary embolism caused by deep vein thrombosis.
[Key words] Deep vein thrombosis; Acute pulmonary embolism; Intervention treatment; Analysis
肺动脉栓塞(PE)是下肢深静脉血栓(DVT)的一种严重并发症[1]。如不能及时有效地进行治疗可导致血栓形成后综合征(PTS)的发生甚至危及患者生命。目前临床中常见的治疗方法有开放手术取栓治疗、抗凝、溶栓等[2]。本院总结多年临床治疗经验，采取双介入方法进行治疗，取得了令人满意的治疗效果，现将具体情况汇报如下：
1资料与方法
1.1 一般资料
入选资料为本院2006～2010年采取双介入治疗的DVT致急性PE的48例患者，以其中置入临时下腔静脉虑器的27例患者作为临时组，以置入永久性下腔静脉滤器的21例患者作为对照组。对照组中，男14例，女7例；年龄为27～68岁，平均(48.29±11.33)岁；发病时间为1～14 d；就诊时平卧下肢静脉压为(43 ......
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