下肢深静脉血栓形成外科治疗分析
Surgical treatment of deep vein thrombosis of lower extremity
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摘要: 目的: 总结下肢深静脉血栓形成(deep vein thrombosis,DVT)手术治疗32例(36条肢体)经验。方法: 32例(36条肢体)下肢DVT患者进行顺行深静脉造影及彩超确诊。运用Fogarty取栓管逆行取栓,29例重建主干血管,其中Palma手术3例,左右股静脉人工血管搭桥23例,股总→髂总静脉搭桥2例,股总→下腔静脉搭桥1例。术中术后用肝素及尿激酶抗凝溶栓治疗。结果: 术后下肢症状完全消失17例(18条肢体),活动后小腿水肿休息后消失9例,3例血栓复发。10天内急性期25条肢体,治愈16例(64.0%),超过10天慢性期治愈4例(36.4%),1例发生肺栓塞。结论: 急性期下肢DVT手术取栓合并主干血管重建效果较好,同时配合术后综合治疗预防血栓复发。Abstract: Objective: To summarize the experience of surgical treatment for patients with deep vein thrombosis(DVT) of the lower extremity.Methods: Thirty-two patients with DVT were diagnosed by ascending lower extremity deep vine angiography or color Doppler ultrasonic examination.All the patients were performed embolectomy with Fogarty.Twenty-nine cases underwent reconstruction,of whom,3 were performed Palma-Dell operation and 26 communis iliac vein femord vein transplantion trans current.The anticoagulant and thrombolytic therapy was used during and after the operation.Results: The swelling in 17 cases(18 lower limbs) faded away completely after operation and the swelling in 9 cases faded away after exerxises.Three cases recurred.The success rate was 16/26(64%) in the acute patients and 4/11(36.3%) in the chronic patients.One patient died of pulmonary embolism.Conclusions: DVT combined with reconstruction was effective for treatment of patient with acute deep vein thrombosis of the lower extremity.Measures should be taken to prevent recurrence after operation.