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目的 探讨下腔静脉滤器置入后大剂量尿激酶溶栓治疗下肢深静脉血栓形成的可行性。方法 1 3例经造影证实为左下肢深静脉血栓患者 ,先于下腔静脉内放置滤器 ,后在监护下经患者足背静脉加压推注尿激酶进行持续溶栓治疗 ,尿激酶 (UK)用量 90 0万U～ 1 60 0万U。疗效判断标准 :痊愈 :患者无症状 ,下肢造影示深静脉通畅 ;显效 :患者症状明显缓解 ,下肢造影示深静脉回流畅 ,但壁不光滑 ,血管内径 >70 % ;有效 :症状有所缓解 ,造影示血栓残留 ,血管内径 <70 % ;无效 :症状及下肢造影均无改善。结果 1 3只下腔静脉滤器均展开良好 ,无移位。其中 :痊愈 2例 ,显效 9例 ,有效 2例 ,无效 0例 ,溶栓过程中未出现肺动脉栓塞症状及出血现象。结论 下腔静脉滤器置入后经患肢浅静脉大剂量尿激酶溶栓治疗下肢深静脉血栓形成是安全、有效的
Objective To investigate the feasibility of high-dose urokinase thrombolysis in the treatment of deep venous thrombosis of lower extremity after inferior vena cava filter implantation. Methods Thirteen patients with deep venous thrombosis confirmed by left ventricle angiography were placed in the inferior vena cava before filter under the care of patients with dorsal venous pressure thrombolysis for continuous thrombolysis urokinase (UK) The dosage of 90 million U ~ 16 million U. Curative effect criteria: recovery: patients asymptomatic, lower limb angiography showed deep vein patency; effective: the patient's symptoms were significantly alleviated, lower limb angiography showed deep venous return smooth, but the wall is not smooth, vascular diameter> 70%; effective: Angiography showed residual thrombosis, vascular diameter <70%; invalid: no improvement in symptoms and lower limb angiography. Results All 13 inferior vena cava filters developed well without displacement. Among them, 2 cases were cured, 9 cases were markedly effective, 2 cases were effective and 0 was ineffective. No pulmonary embolism symptoms and hemorrhage occurred during thrombolysis. Conclusions The treatment of deep venous thrombosis of lower extremity after thrombolysis of inferior vena cava with high-dose urokinase in superficial vein is safe and effective