Abstract: Objective To investigate clinical outcome of thrombolytic therapy for subacute deep venous thrombosis （sDVT） and to summarize our single-center experience. Methods During the period from 2014 to 2019, those patients who were diagnosed with sDVT and accepted thrombolytic therapy were included, and their clinical and follow-up data were retrospectively collected and analyzed. Results A total of 23 patients were involved, including 11 males and 12 females. The average age was 35.2±11.7 years old. Of these, thrombolytic therapy was performed in 8 patients via dorsalis pedis vein, and in 7 patients via popliteal vein. Femoral artery access was established in 1 patient, while femoral vein access in another patient. The remaining 6 patients experienced thrombolytic therapy via femoral vein in combination with popliteal vein. Assistant strategies included ballon dilation, stent implantation or thrombectomy were performed in 6 patients. During the period of thrombolytic therapy, 1 patient experienced gastrointestinal bleeding and recovered after conservative treatment. After thrombolytic therapy, angiography or ultrasound revealed that complete and partial thrombus dissolution was achieved in 6 and 8 patients, while no thrombus dissolution was found in 9 patients. Complete or partial thrombus dissolution was confirmed in all 6 patients accepted assistant strategies. The thigh and calf circumference were decreased by 2.8（2.4）cm （P=0.003） and 3.8（2.9） cm （P=0.001） after therapy, respectively. Conclusion Thrombolytic therapy is safe and effective for patients with sDVT. The access used for therapy should be established flexibly according to lesion range and thrombolytic effect. Assistant strategies, including balloon, stent and thrombectomy, can improve the effectiveness of thrombolytic therapy.

Key words: deep venous thrombosis, subacute stage, interventional strategies, thrombolytic therapy

摘要： 目的 探讨溶栓治疗亚急性下肢深静脉血栓（sDVT）的疗效及总结单中心经验。方法 自2014年至2019年期间,所有在我院诊断为sDVT,并接受溶栓治疗患者纳入研究,收集并分析临床和随访资料。结果 本研究共纳入23名患者,其中男性11名,女性12名,平均年龄35.2±11.7岁。溶栓入路采用足背静脉者8例,采用腘静脉7例,采用对侧股静脉和股动脉者各1例,联合或者序贯采用足背静脉和腘静脉者有6例。辅助采用球囊扩张、支架者或者血栓清除者有6例。溶栓过程中,发生消化道出血1例,经过保守治疗后好转。溶栓后,分别有6例实现完全溶解,8例实现部分溶解,9例无明显缓解。其中,采用辅助策略的例患者均实现了完全溶解或者部分溶解。术后大腿和小腿的腿围分别减小2.8（2.4）cm（P=0.003）和3.8（2.9）cm（P=0.001）。结论 对于sDVT患者,溶栓治疗仍然有良好的效果并具有较高的安全性。溶栓入路根据病变范围和溶栓效果灵活采用。辅助策略包括球囊、支架、AnjioJet血栓清除装置等,可能提高溶栓的效果。

关键词: 亚急性期, 溶栓治疗, 下肢深静脉血栓形成, 介入治疗