目的 分析AngioJet血栓抽吸联合髂静脉支架在下肢深静脉血栓合并髂静脉压迫的临床疗效。方法 2016年1月—2019年6月在揭阳市人民医院普外一科收治的首发髂股DVT并在AngioJet吸栓或联合导管溶栓后置入支架的患者,比较吸栓后直接支架置入和溶栓再分期支架置入的治疗效果。结果 本研究共纳入50例接受支架手术的DVT患者,其中治疗组29例,分期置入组21例。治疗组临床症状缓解率和住院时间优于对照组,差异有统计学意义(P＜0.05),且出血风险更低。 而置入支架长度和直径无差异,治疗组的3个月、6个月和12个月的通畅率、静脉返流时间和 Villalta评分均无差异(P＞0.05)。结论 AngioJet血栓清除后直接支架置入术是治疗合并髂静脉压迫的下肢深静脉血栓的有效方法,临床改善更快,住院时间显著缩短。

Objective To analyze the clinical effect of AngioJet thrombus aspiration combined with iliac vein stent in deep vein thrombosis of the lower extremity with iliac vein compression. Methods From January 2016 to June 2019, patients with first iliofemoral DVT and stent implantation after AngioJet thrombolysis or combined catheter thrombolysis were treated in the first department of general surgery, Jieyang People's Hospital. The therapeutic effects of direct stent implantation and stent implantation after thrombolysis were compared. Results A total of 50 patients with DVT who underwent stent surgery were included in this study, including 29 in the treatment group and 21 in the staging group. The clinical symptom relief rate and length of stay in the treatment group were better than those in the control group, the difference was statistically significant (P<0.05), and the risk of bleeding was lower. There was no significant difference in stent length and diameter. There were no significant differences in patency rate, venous reflux time, and Villalta score in the treatment group at 3 months, 6 months, and 12 months (P>0.05). Conclusion Direct stent placement after AngioJet thrombectomy is an effective method for treating deep venous thrombosis of lower limbs with iliac vein compression. The clinical improvement is faster and the length of hospital stay is significantly shortened.

目的 探讨快速康复外科理念对降低子宫全切术后患者下肢深静脉血栓形成的应用效果。方法 采用方便抽样的方法,将185例子宫全切术后患者分为观察组(95例)和对照组(90例)。观察组实施快速康复外科护理路径,对照组实施常规护理路径。结果 两组患者术后的下肢深静脉血栓发生率、D-二聚体水平、日常生活活动能力评分的比较差异均有统计学意义(P<0.05);观察组下肢深静脉血栓形成的发生率和D-二聚体水平低于对照组(P<0. 01),观察组日常生活活动能力评分低于对照组(P<0.05)。结论 快速康复外科理念应用于子宫全切术后患者,可降低患者下肢深静脉血栓的发生率,提高患者自理能力,使患者尽快恢复健康水平。

Objective To explore the effect of fast-track surgery on the treatment of lower extremity deep venous thrombosis in patients after total hysterectomy. Methods A total of 185 patients with hysterectomy were divided into observation group(n=95) and control group (n=90) randomly. The observation group implemented a rapid rehabilitation surgical care path, and the control group implemented routine nursing path. Results There were significant differences in the incidence of deep venous thrombosis, D-dimer level and daily living activity score between the two groups (P<0.05). The incidence of deep venous thrombosis and the level of D-dimer in the lower extremity of the observation group were significantly lower than those in the control group (P<0.01). The score of the daily living activity was lower in the observation group than that of control group (P<0.05). Conclusion Fast-track surgery for patients after total hysterectomy could reduce the incidence of postoperative deep venous thrombosis and improve the self-care abilities of patients, so that patients may return to health as soon as possible.