导管溶栓治疗下肢深静脉血栓形成近期疗效的影响因素分析

doi:10.3760/cma.j.cn101202-20210902-00245

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摘要目的探讨导管溶栓（CDT）治疗下肢深静脉血栓形成（DVT）近期疗效的影响因素。方法回顾性病例对照研究。选取蚌埠医学院第一附属医院2017年11月—2021年3月129例接受CDT治疗的下肢DVT患者的临床资料,其中男56例、女73例,年龄（43.3±6.1）岁。根据CDT治疗的近期效果分为2组：再通组（血栓溶解率≥50%）和未通组（血栓溶解率<50%）,其中未通组57例,再通组72例,对2组患者的临床资料进行单因素分析,将差异有统计学意义（P<0.05）的指标进行多因素logistic回归分析。结果单因素分析显示,2组患者的年龄、病程、恶性肿瘤、血小板计数、纤维蛋白原及CDT前行髂静脉小球囊预扩张等因素比较,差异均有统计学意义（P值均<0.05）;进一步多因素logistic回归分析结果显示：年龄>60岁[比值比（OR） 3.261,95%可信度区间（CI）1.361~7.815,P=0.008]、病程>14 d（OR 6.755,95%CI 1.826~24.985,P=0.004）、纤维蛋白原（OR 1.459,95%CI 1.055~2.018,P=0.023）与CDT前行髂静脉小球囊预扩张（OR 5.666,95%CI 1.325~24.235,P=0.019）是CDT治疗下肢DVT近期疗效的独立影响因素。结论年龄、病程、纤维蛋白原、CDT前行髂静脉小球囊预扩张是CDT治疗DVT近期疗效的独立影响因素。

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关键词 ：静脉血栓形成, 下肢深静脉血栓形成, 导管溶栓, 影响因素

Abstract：Objective To explore the factors that affect the short-term efficacy of catheter-directed thrombolysis (CDT) in the treatment of lower extremity deep venous thrombosis (DVT). Methods A retrospective case-control study was conducted to analyze the clinical data of 129 patients with lower limb DVT treated by CDT in the First Affiliated Hospital of Bengbu Medical College from November 2017 to March 2021. The patients included 56 males and 73 females aged 43.3±6.1 years old. The patients were divided into two groups according to the therapeutic effect of CDT, namely, the recanalization group (thrombolysis rate ≥50%, n=57) and non-recanalization group (thrombolysis rate <50%, n=72). The clinical data of the two groups were analyzed by univariate analysis, and the indexes with statistically significant difference were analyzed by multivariate logistic regression analysis. Results Univariate analysis showed significant differences in age, disease course, malignant tumor, platelet, fibrinogen, and iliac vein balloon predilatation before CDT between the two groups. The results of multivariate logistic regression analysis showed that age (odds ratio[OR]=3.261,95% confidence interval [CI]=1.361-7.815), disease course >14 d (OR=6.755, 95% CI=1.826-24.985), fibrinogen (OR=1.459, 95% CI=1.055-2.018), and iliac vein balloon predilatation before CDT (OR=5.666, 95% CI=1.325-24.235) affect the therapeutic effect of CDT. Conclusion Age, disease course, fibrinogen, and iliac vein balloon dilatation before CDT are independent factors that affect the short-term efficacy of CDT as DVT treatment.

Key words： Venous thrombosis Lower extremity deep venous thrombosis Catheter-directed thrombolysis Influencing factors

收稿日期: 2021-09-02

基金资助:蚌埠医学院研究生创新计划（Byycx20095）

通讯作者: 高涌,Email：Dr.gaoyong@163.com

引用本文:

李雷, 余朝文, 高涌. 导管溶栓治疗下肢深静脉血栓形成近期疗效的影响因素分析[J]. 中华解剖与临床杂志, 2022, 27(5): 349-352.
Li Lei, Yu Chaowen, Gao Yong. Factors affecting the short-term efficacy of catheter-directed thrombolysis in the treatment of lower extremity deep venous thrombosis. Chinese Journal of Anatomy and Clinics, 2022, 27(5): 349-352.

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http://www.cjac.com.cn/CN/10.3760/cma.j.cn101202-20210902-00245 或 http://www.cjac.com.cn/CN/Y2022/V27/I5/349

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