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目的探讨超声多普勒在急性下肢深静脉血栓形成(DVT)患者局部插管溶栓中的应用价值。方法选取2014年7月至2015年11月收治的32例急性下肢DVT患者为观察对象,术前经健侧股静脉置入下腔静脉滤器,在超声引导下,穿刺患侧腘静脉,插入溶栓导管。微泵持续注入尿激酶,24 h后超声监测。结果超声定位下穿刺针均顺利进入腘静脉;超声引导下溶栓导管均被置入血栓合适位置,32例超声引导全部成功。治疗过程中,根据血栓消融情况,3例在超声引导下调整了溶栓导管位置。经过2~7 d溶栓治疗后行超声复查,31例基本治愈,1例好转。无1例发生大出血和肺栓塞。结论超声检查在急性下肢DVT患者局部插管溶栓术前诊断、术中引导、术后指导用药及疗效评估方面具有一定临床应用价值。
Objective To investigate the value of ultrasound Doppler in the local intubation and thrombolysis in patients with acute lower extremity deep vein thrombosis (DVT). Methods Thirty-two patients with acute lower extremity DVT admitted to our hospital from July 2014 to November 2015 were enrolled in the inferior vena cava filter through the contralateral femoral vein and under the guidance of ultrasound to puncture the ipsilateral veins. Bolt catheter. Micro-pump continued urokinase infusion, 24 h after ultrasound monitoring. Results Ultrasound guided puncture needle successfully entered the veins; under the guidance of ultrasound thrombolytic catheter were placed in the appropriate position of the thrombus, 32 cases of ultrasound guided all successful. During treatment, thrombolytic catheter placement was adjusted in 3 cases under ultrasound guidance, based on ablation of the thrombus. After 2 ~ 7 d thrombolytic therapy after ultrasound review, 31 cases were basically cured, 1 case improved. No case of massive bleeding and pulmonary embolism occurred. Conclusion Ultrasonography has some clinical value in the diagnosis of local intubation and thrombolysis in DVT patients with acute lower extremities, guidance in operation, guidance of medication after operation and efficacy evaluation.