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目的下肢深静脉血栓(DVT)是导致急性肺栓塞(APE)最常见病因,及时正确诊断DVT可预防APE发生。方法临床拟诊DVT患者29例,男21例,女8例,年龄(46±12．9)岁,静脉注射MAA 5 mci,行核素双下肢造影,分析双下肢造影即刻相及5 min延迟相。DVT明确诊断后置入下腔静脉滤器(ICF),予尿激酶静脉溶栓,低分子肝素1 mg／kg、12 h／次皮下注射,继华法令口服,监测INR在2-3之间,全部患者随访2-8个月,观察双下肢肿胀及胸闷、气短、胸痛、咯血及晕厥发生。结果24例患者经核素双下肢造影诊断为DVT,显像结果以5 min延迟相为依据,于成功置入ICF后,经抗凝、溶栓等处理,下肢静脉栓塞症状明显缓解,随访2-8个月无肺栓塞发生。结论核素下肢静脉造影是诊断DVT有效手段,根据该检查结果,及时选择有效治疗方法,可避免更为严重的临床事件。
Purpose DVT is the most common cause of acute pulmonary embolism (APE), and timely and correct diagnosis of DVT can prevent the occurrence of APE. Methods Twenty-nine patients with DVT were enrolled in this study. They were 21 males and 8 females, aged 46 ± 12.9 years. Intravenous MAA 5 mci was used. phase. DVT was diagnosed and placed in the inferior vena cava filter (ICF), urokinase intravenous thrombolysis, low molecular weight heparin 1 mg / kg, 12 h / subcutaneous injection, following oral warfarin, monitoring INR between 2-3, All patients were followed up for 2-8 months, observed swelling and chest lower limbs, shortness of breath, chest pain, hemoptysis and syncope occurred. Results 24 patients were diagnosed as DVT by radionuclide two lower limbs angiography. The imaging results were based on 5 min delay phase. After successful ICF implantation, the symptoms of lower extremity venous embolism were relieved by treatment with anticoagulation and thrombolysis. -8 months without pulmonary embolism. Conclusions Radionuclide venography is an effective method to diagnose DVT. According to the results of the examination, timely and effective treatment can avoid more serious clinical events.