摘要
目的探讨下腔静脉滤器(IVCF)置入联合导管溶栓治疗下肢深静脉血栓形成(DVT)患者静脉通畅率的相关因素。方法选取2014年3月至2017年3月于驻马店市中心医院行IVCF置入联合导管溶栓治疗的下肢DVT患者120例,治疗后按照静脉通畅率将患者分为疗效差组(通畅率<50%)和疗效佳组(通畅率≥50%),对2组患者的临床资料进行比较,并采用logistic回归模型分析下肢DVT患者行IVCF置入联合导管溶栓治疗后静脉通畅率的影响因素。结果 120例下肢DVT患者中,静脉通畅率<50%者62例(疗效差组),静脉通畅率≥50%者58例(疗效佳组)。疗效佳组并发高血压、糖尿病、恶性肿瘤的患者比例显著低于疗效差组(P<0.05),2组患者DVT分期及发病部位比较差异有统计学意义(P<0.05),疗效佳组患者血小板计数、白细胞计数及血浆纤维蛋白原水平显著低于疗效差组(P<0.05)。2组患者的性别、年龄、手术史、外伤史及D-二聚体水平比较差异均无统计学意义(P>0.05)。多因素logistic回归分析结果显示,白细胞计数、血浆纤维蛋白原、DVT分期、发病部位是下肢DVT患者行IVCF置入联合导管溶栓治疗后静脉通畅率的影响因素(P<0.05),但并发高血压、糖尿病、恶性肿瘤及血小板计数与患者静脉通畅率无相关性(P>0.05)。结论白细胞计数、血浆纤维蛋白原、DVT分期、发病部位是下肢DVT患者行IVCF置入联合导管溶栓治疗后静脉通畅率的影响因素,应针对影响因素制定相关措施,以提高治疗效果。
Objective To investigate the influencing factors for venous patency rate in patients with deep venous thrombosis( DVT) of lower limbs treated with inferior vena cava filter( IVCF) combined with catheter-directed thrombolysis. Methods A total of 120 patients with DVT of lower limbs who underwent IVCF combined with catheter-directed thrombolysis were selected from March 2014 to March 2017 in Zhumadian Central Hospital. The patients were divided into poor effect group( patency rate < 50%) and good effect group( patency rate ≥ 50%) according to venous patency rate after treatment. The clinical data were compared between the two groups. The influencing factors for venous patency rate in patients with DVT of lower limbs after IVCF placement and catheter-directed thrombolysis were analyzed by logistic regression. Results Among the 120 patients with DVT of lower limbs,the venous patency rate was less than 50% in 62 cases( poor effect group),and the venous patency rate was equal to or greater than 50% in 58 cases( good effect group). The proportion of patients with high blood pressure,diabetes mellitus and malignant tumor in good effect group was significantly lower than that in poor effect group( P <0. 05); there was a significant difference in DVT staging and location between the two groups( P < 0. 05); the levels of platelet count,white blood cell count and plasma fibrinogen in good effect group were significantly lower than those in poor effect group( P < 0. 05). There was no significant difference in sex,age,operation history,trauma history and D-dimer level between the two groups( P > 0. 05). Multivariate logistic regression analysis showed that white blood cell count,plasma fibrinogen,DVT staging and location were the influencing factors for venous patency rate after IVCF placement and catheter-directed thrombolysis in patients with DVT of lower limbs( P < 0. 05); but hypertension,diabetes mellitus,malignant tumor and platelet count were not related to the venous patency rate( P > 0. 05). Conclusion White blood cell count,plasma fibrinogen,DVT staging and location are the influencing factors for venous patency rate after IVCF placement and catheter-directed thrombolysis in patients with DVT of lower limbs. Relevant measures should be formulated in order to improve the treatment effectiveness.
出处
《新乡医学院学报》
CAS
2018年第2期154-157,共4页
Journal of Xinxiang Medical University
关键词
下肢深静脉血栓形成
下腔静脉滤器
导管溶栓
影响因素
deep venous thrombosis of lower limbs
inferior vena cava filter
catheter-directed thrombolysis
influencing factor
作者简介
贾浩（1979-）,男,河南驻马店人,学士,主治医师,研究方向：血管外科疾病.
