目的比较经下肢静脉顺行溶栓和经上肢静脉溶栓治疗下肢深静脉血栓形成(DVT)的疗效及副作用,以探讨更好的治疗方法。方法共收集 DVT 患者128例,治疗组58例,采用尿激酶联合低分子量肝素经下肢静脉顺行溶栓治疗;对照组70例,采用尿激酶联合肝素经上肢静脉溶栓治疗。均观察两组治疗前和治疗后7 d、14 d、28 d 的凝血功能及疗效。结果治疗组血管总再通率比对照组显著为高(P<0.05),平均再通天数显著短于对照组(P<0.01),凝血功能在治疗组控制更好,并发症显著少于对照组(P<0.05)。结论采用大剂量尿激酶联合低分子量肝素经下肢静脉顺行溶栓治疗 DVT,疗效更确切,且安全易行,副作用少。 Objective To compare the curative effects and side effects of paravenous thrombolysis of the lower extremities and thrombolysis of the upper extremities in the treatment of deep venous thrombosis of the lower extremities (DVT) to explore better therapeutic methods. Methods A total of 128 patients with DVT were collected. The treatment group was treated with urokinase combined with low molecular weight heparin through paraventricular thrombolysis in the lower extremity. In the control group, 70 patients were treated with urokinase plus heparin via upper limb venous thrombolysis. Both groups were observed before and after treatment 7 d, 14 d, 28 d coagulation function and efficacy. Results The total vascular recanalization rate in the treatment group was significantly higher than that in the control group (P <0.05), and the mean recanalization days were significantly shorter than those in the control group (P <0.01). The coagulation function was better controlled and the complication rate was significantly lower in the treatment group Group (P <0.05). Conclusion High dose of urokinase combined with low molecular weight heparin through the lower extremity vein parallel thrombolytic therapy of DVT, the effect is more accurate, safe and easy to operate, with fewer side effects.