血管腔内同期治疗肺栓塞合并下肢深静脉血栓的临床研究

Clinical Study of Endovascular Concurrent Treatment of Pulmonary Embolism Combined with Lower Extremity Deep Venous Thrombosis

摘要: 目的：探讨血管腔内同期治疗肺栓塞合并下肢深静脉血栓的临床效果。方法：回顾性分析了我院近5年确诊的36例患者临床资料，所有患者在下腔静脉滤器的保护下对肺动脉和下肢深静脉行球囊扩张建立血流通道，留置溶栓导管对残留的血栓继续溶栓治疗。记录患者治疗结束后生命体征和肺动脉压变化，血管开通情况以及治疗过程中不良事件发生情况。术后对患者随访1年。结果：患者术后生命体征、患者肺动脉压、Miller评分以及下肢血栓评分均较术前明显改善，差异具有统计学意义(P < 0.05)，治疗过程中无不良事件发生。术后随访1年可见2例血栓后综合症以及1例慢性血栓栓塞性肺动脉高压。结论：血管腔内同期治疗肺栓塞合并下肢深静脉血栓是一种安全有效的治疗方式，可以在临床实践中推广及应用。

Abstract: Objective: The objective is to investigate the clinical effect of concurrent intravascular treatment of pulmonary embolism complicated with deep venous thrombosis of lower extremity. Methods: The clinical data of 36 patients diagnosed in our hospital in recent 5 years were retrospectively analyzed. All patients underwent balloon dilation of pulmonary artery and deep vein of lower limb to establish blood flow channel under the protection of inferior vena cava filter, and continued thrombolytic therapy for residual thrombosis with indwelling thrombolytic catheter. The changes of vital signs, pulmonary artery pressure, vascular opening and adverse events during treatment were recorded after treatment. Patients were followed up for 1 year after surgery. Results: Postoperative vital signs, pulmonary artery pressure, Miller score and lower limb thrombosis score were significantly improved compared with those before surgery, and the differences were statistically significant (P < 0.05). No adverse events occurred during treatment. One year of follow-up showed 2 cases of post-thrombotic syndrome and case of chronic thromboembolic pulmonary hypertension. Conclusion: Intravascular concurrent treatment of pulmonary embolism complicated with deep venous thrombosis of lower extremity is a safe and effective treatment method, which can be popularized and applied in clinical practice.