| 成咏.髂静脉受压综合征合并急性下肢深静脉血栓的腔内治疗与护理[J].上海护理,2015,15(7): |
| 髂静脉受压综合征合并急性下肢深静脉血栓的腔内治疗与护理 |
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| 投稿时间：2014-07-01 修订日期：2014-07-09 |
| DOI： |
| 中文关键词: 髂静脉受压综合征 急性下肢深静脉血栓 腔内治疗 护理 |
| 英文关键词:Key words：iliac vein compression syndrome acute deep venous thrombosis endovascular treatment nursing |
| 基金项目:本课题获国家自然基金支持项目(项目批准号：81370423) |
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| 中文摘要: |
| 摘要：目的 探讨髂静脉受压综合征合并急性下肢深静脉血栓的腔内治疗与护理体会。方法 回顾分析2008年3月至2014年5月共45例髂静脉受压综合征合并急性下肢深静脉血栓患者在DSA下行下肢深静脉内导管溶栓术（catheter directed thrombolysis，CDT），37例同时行球囊扩张并支架置入治疗，8例3～6个月后行球囊扩张并支架置入治疗。以健、患肢周径差及深静脉通畅度来评价疗效。结果 45例患者溶栓过程中无肺梗死、导管滑出、药物过敏反应、内脏出血等并发症出现，仅有9例发生一般出血现象包括：5例患者切口部位有少量皮下血肿未处理自行吸收、2例患者穿刺处渗血、2例患者尿路出血，因早期发现及时，经过对症处理后未进一步出血。腔内治疗后经顺行静脉造影确认所有患肢深静脉通畅率较前明显改善，患肢症状明显好转。结论 静脉腔内导管溶栓结合球囊扩张及支架置入术是治疗髂静脉受压综合征合并急性下肢深静脉血栓形成的有效手段。术前做好患者的心理护理、完善各项术前准备，术后密切观察病情、加强并发症的观察及处理是确保腔内手术成功的关键。 |
| 英文摘要: |
| Abstract ：Objective To assess the endovascular treatment and nursing experience on iliac vein compression syndrome with acute deep venous thrombosis. Methods A retrospective analysis of 45 patients with iliac vein compression syndrome and acute deep venous thrombosis was conducted from March 2008 to May 2014. All patients were performed catheter directed thrombolysis (CDT) by Digital Subtraction Angiography (DSA). Balloon dilatation and stenting treatments were selectively performed in 37 patients and the other 8 patients were performed with balloon dilatation and stenting treatments after 3 to 6 months. Quality of life and the severity of venous disorders were evaluated by health, limb circumference difference and deep vein patency. Results There are no serious complications in the 45 patients. Only 9 patients were with minor bleeding, including 5 patients with small hematoma at the incision site with no further treatment, 2 patients at the puncture site, and 2 patients with urinary tract bleeding, All the patients were performed symptomatic treatments, and there are no further bleeding. Venography confirmed deep vein patency and the quality of life were improved signi?cantly after endovascular treatments. The limb complications were minor and improved quickly.
Conclusion CDT combined with balloon dilatation and stenting was an effective method for treating iliac vein compression syndrome with acute deep venous thrombosis. Preoperative psychological care of patients, improve the preoperative preparation and postoperative close observation, strengthen observation and treatment of complications is key element to ensuring the success of endovascular surgery. |
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