Abstract: Objective To investigate the clinical efficacy on treatment of lower extremity deep venous thrombosis with thrombolysis combined with iliofemoral vein stenting and anticoagulation. Methods The data of 79 cases were analyzed from June 2016 to January 2019. And the patients were divided into operation group and anticoagulation group according to different treatment methods. The short-term and long-term treatment effect, and stent patency were compared and analyzed. Result There were 31 patients in the operation group and 48 patients in the anticoagulation group. The average decrease of the circumference of the 10 cm below the patella in the operation group was （4.83±1.26） cm, and that in the anticoagulation group was （2.75±0.82） cm, and the difference was statistically significant. At average of 18 months′ follow-up, the incidence of PTS in the operation group was 25.8% compared with 57.8% in control group（P=0.004）. The overall primary patency of stent was 80.6%. The average onset time of the operation group was 5.2 days, while the average villalta score was 6.5. The pearson correlation analysis showed that the onset time was positively correlated with Villalta score, indicating that the earlier the thrombus was treated the better outcome would be concluded. Conclusion CDT combined with stenting is a safe and effective method for the treatment of acute deep venous thrombosis of lower extremities, and the incidence of post thrombotic syndrome is low.

Key words: DVT, CDT, stent, PTS

摘要： 目的 对比手术溶栓联合髂静脉支架置入与抗凝治疗急性下肢深静脉血栓的疗效。方法 收集我科2016年6月~2019年1月期间治疗的下肢深静脉血栓79例患者,根据治疗方式分为手术组与抗凝组,对比分析近期治疗效果、远期治疗效果与支架通畅情况等。结果 手术组31例,抗凝组48例;手术组患肢髌骨下10 cm周径下降值平均为4.83±1.26 cm,抗凝组为2.75±0.82 cm,差别有统计学意义（P<0.05）;平均随访18个月,手术组PTS发生率为25.8%,抗凝组发生率为57.8%;支架1期通畅率为80.6%,手术组平均发病时间为5.2天,随访后villalta平均评分为6.5,pearson相关分析显示发病时间与villalta评分的呈正相关,说明血栓越早治疗效果较好。结论 采用导管溶栓联合支架手术治疗急性下肢深静脉血栓形成的疗效确切、血栓后综合征发生率较低,是安全有效的治疗手段。

关键词: 下肢深静脉血栓形成, 导管溶栓, 支架置入, 血栓形成后综合征