Straub血栓旋切器在下肢深静脉血栓形成中的临床应用

吴卫东+杨莉++黄许光++周桂勤++万波

[摘要]目的 探討Straub血栓旋切器在下肢深静脉血栓形成中的应用效果。方法 随机选取2009年10月～2013年8月于我院就诊并治疗的88例下肢深静脉血栓形成患者，采取简单随机化的分组方法将其分为观察组和对照组，每组44例。对照组患者给予药物溶栓治疗，观察组患者给予Sraub血栓旋切器介入性治疗方案。比较两组患者的下肢周径下降变化、痊愈率、并发症发生率以及静脉瓣功能情况。结果 术后平均随访（27.2±10.9）个月，观察组患者下肢周径下降（4.0±1.2）cm，对照组为（1.3±0.5）cm，观察组的痊愈率为90.8%，对照组为34.2%，两组差异有统计学意义（P<0.05）。观察组的并发症发生率明显低于对照组，静脉瓣功能情况明显优于对照组（P<0.05）。结论 Straub血栓旋切器在下肢深静脉血栓形成中的应用效果相比于单纯药物溶栓治疗更高效，且具有安全，能快速地清除血栓、恢复正常血流的特点，可减少由于静脉回流障碍所致的并发症，值得临床推广应用。

[关键词]Straub血栓旋切器；下肢深静脉血栓；静脉瓣功能

[中图分类号] R543.6 [文献标识码] A [文章编号] 1674-4721（2017）07（c）-0024-03

Clinical application of Straub thrombus rotary cutter in lower extremity deep venous thrombosis

WU Wei-dong YANG li HUANG Xu-guang ZHOU Gui-qin WAN Bo

Department of Vascular Surgery，the Third People′s Hospital of Jiujiang City in Jiangxi Province，Jiujiang 332000，China

[Abstract]Objective To explore the application effect of Straub thrombus rotary cutter in lower extremity deep venous thrombosis.Methods 88 patients with lower extremity deep venous thrombosis treated in our hospital from October 2009 to August 2013 were randomly selected.Patients were divided into observation group and control group according to the simple randomization principle，and each group had 44 cases.The control group was given drug thrombolysis treatment，while the observation group was given the plan of Straub thrombus rotary cutter interventional therapy.The change of the diameter of the lower extremity，cure rate，the incidence of complications and venous valve function of patients between the two groups were compared.Results The mean follow-up was （27.2±10.9） months.The decrease of diameter of the lower extremity in observation group and control group was （4.0±1.2） cm and （1.3±0.5） cm respectively，and the cure rate in observation group and control group was 90.8% and 34.2% respectively，and the difference between two groups was significant （P<0.05）.Incidence of incidence of complications in observation group was obviously lower than that in control group （P<0.05）.The venous valve function in observation group was obviously better than that in control group （P<0.05）.Conclusion The application effect of Straub in lower limbs deep venous thrombosis is more effective than that of the single drug thrombolytic therapy，and it has the advantages of safety，quickly clearing thrombus and resuming normal blood flow，reducing complications due to venous reflux disorder.It is worthy of clinical promotion and application.

[Key words]Straub thrombus rotary cutter；Lower extremity deep venous thrombosis；Venous valve function

近年来，下肢深静脉血栓形成（deep venous thrombosis，DVT）逐渐成为血管外科常见的、危害性较大的比较难治的疾病，急性下肢静脉血栓如不及时诊断和处理，46%～50%的患者可因血栓脱落并发最严重的、死亡率较高的并发症肺栓塞（pulmonary embolism，PE）[1-2]。Straub血栓旋切器是在数字血管减影下，通过导管技术对药物难溶的陈旧血栓以及对新鲜血栓具有良好的清除作用[3]，高速旋切并吸取，高效地将血栓裂解成碎片状并清除血栓，达到解除栓塞和重建患者血管内循环的作用[4]。为探讨Straub血栓旋切器在下肢DVT中的临床应用效果，现回顾性分析于我院就诊并治疗的88例下肢DVT患者的临床资料并报道如下。

1 资料与方法

1.1一般资料

随机选取自2009年10月～2013年8月于我院就诊并治疗的88例下肢DVT的患者，采取简单随机化的分组方法将其分为观察组和对照组，每组44例。……