黎杨杨 林裕锋 黄小琴

【摘要】 目的：探讨经导管溶栓治疗下肢深静脉血栓（DVT）患者对凝血-纤溶指标的影响。方法：选取2017年1月-2019年10月本院采用经导管溶栓治疗的60例DVT患者设为病例组，60例健康体检对象设为对照组。检测两组的D-二聚体（D-D）、纤维蛋白原（FIB）、纤维蛋白降解产物（FDP）、凝血酶原时间（PT）、活化部分凝血酶时间（APTT）、凝血酶时间（TT）、血栓弹力图指标。结果：治疗72 h，病例组的D-D、FIB、FDP值较治疗前均降低，但均高于对照组，差异均有统计学意义（P<0.05）。治疗72 h，病例组的PT、APTT均较治疗前上升，TT值较治疗前下降，但病例组PT、APTT均低于对照组，TT值高于对照组，差异均有统计学意义（P<0.05）。治疗72 h，病例组的R值、K值均较治疗前上升，MA值、α角较治疗前均降低，但病例组的R值、K值均低于对照组，MA值、α角均高于对照组，差异均有统计学意义（P<0.05）。结论：经导管溶栓治疗下肢DVT患者能有效改善患者的凝血-纖溶指标，治疗过程中应该密切监测，避免严重的不良反应发生。

【关键词】 经导管溶栓 下肢深静脉血栓 凝血功能 纤溶指标

Effect of Coagulation-fibrinolysis Index in Transcatheter Thrombolytic Therapy of DVT/LI Yangyang， LIN Yufeng， HUANG Xiaoqin. //Medical Innovation of China， 2021， 18（01）： -121

[Abstract] Objective： To investigate the effect of transcatheter thrombolysis on coagulation-fibrinolysis indicators in patients with deep vein thrombosis （DVT）. Method： A total of 60 patients with DVT treated by transcatheter thrombolysis therapy in our hospital from January 2017 to October 2019， were selected as the case group， 60 healthy subjects were selected as the control group. Polymers （DD）， fibrinogen （FIB）， fibrin degradation products （FDP）， prothrombin time （PT）， activated partial thrombin time （APTT）， thrombin time （TT）， thrombelastogram index. Result： After 72 h of treatment， D-D， FIB and FDP values in the case group were lower than those before treatment， but higher than those in the control group， the differences were statistical significance （P<0.05）. At 72 h of treatment， PT and APTT in the case group were higher than before treatment， TT value was lower than before treatment， but PT and APTT in the case group were lower than those in the control group， TT value was higher than the control group， the differences were statistical significance （P<0.05）. After 72 h of treatment， R value and K value of the case group were increased compared with before treatment， MA value and Angle of the case group were decreased compared with before treatment， but R value and K value of the case group were lower than those in the control group， MA value and Angle were higher than those in the control group， the differences were statistically significant （P<0.05）. Conclusion： Transcatheter thrombolytic therapy in patients with lower extremity DVT can effectively improve the patients coagulation-fibrinolysis index， and should be closely monitored during treatment to avoid serious adverse reactions.

[Key words] Transcatheter thrombolysis Deep vein thrombosis of lower limbs Coagulation function Fibrinolysis index

First-authors address： Yangjiang Peoples Hospital， Yangjiang 529500， China

doi：10.3969/j.issn.1674-4985.2021.01.030

下肢深静脉血栓形成又名下肢深静脉血栓，是指静脉血液在下肢深静脉血管内的形成凝结，产生血栓的现象[1]。该病最常见的表现是一侧肢体的突然肿胀，局部感疼痛，行走时加剧，且不同病情患者症状也大不相同，轻者局部仅感沉重，站立时症状加重[2]。治疗方式包括卧床休息、抬高患肢、抗凝疗法、溶栓治疗、深静脉血栓的长期治疗等，根据具体病情选择最佳治疗手段，其中导管溶栓是下肢DVT的主要治疗方法[3]。本研究探讨经导管溶栓治疗后下肢DVT患者对凝血-纤溶指标的影响，分析治疗前后DVT患者凝血-纤溶指标的变化，现报道如下。

1 资料与方法

1.1 一般资料 选取2017年1月-2019年10月本院采用经导管溶栓治療的DVT患者60例设为病例组，健康体检对象60例设为对照组。纳入标准：（1）下肢骨折手术或关节置换术后出现下肢深静脉血栓;（2）患者年龄19～79岁;（3）DVT患者经血管超声、静脉血管造影等检查确诊;（4）患者出现患侧下肢肿胀、皮纹消失、疼痛。……