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目的评价经腘静脉置管溶栓治疗脑梗死合并急性下肢深静脉血栓形成患者的临床应用价值。方法脑梗死合并急性下肢深静脉血栓患者34例,按患肢肌力高低分为两组,肌力较低组(0～Ⅱ级)23例,肌力较高组(Ⅲ～Ⅳ级)11例。所有患者在B超引导下经腘静脉置入溶栓导管,经溶栓导管持续泵入尿激酶10～14天,同时行抗凝治疗。监测凝血酶原时间、颅脑CT。结果溶栓疗效显著者30例,其中治愈12例,显效18例,有效4例,显效率88.2%,总有效率为100%,肌力较高组血管完全再通率高。所有病例均无肺动脉栓塞症及严重出血并发症。随访期间2例复发,均为肌力较低患者。结论对脑梗死伴下肢深静脉血栓形成的患者行置管溶栓治疗安全,效果良好。患肢肌力较低者易复发,需注意随访。
Objective To evaluate the clinical value of intravenous thrombolysis in patients with acute cerebral infarction complicated by acute deep venous thrombosis. Methods Thirty-four patients with cerebral infarction complicated by acute lower extremity deep venous thrombosis were divided into two groups according to the muscle strength of the limbs. There were 23 cases with lower strength group (0 ~ Ⅱ grade) and 11 with higher strength group (Ⅲ ~ Ⅳ grade). example. All patients underwent B-guided thrombolysis via thoracic vein. Urokinase was continuously pumped through thrombolytic catheter for 10 to 14 days, meanwhile anticoagulant therapy was performed. Monitor prothrombin time, brain CT. Results Thrombolytic therapy was significant in 30 cases, of which 12 cases were cured, 18 cases markedly effective in 4 cases, markedly effective rate of 88.2%, the total effective rate was 100%, high strength group of vessels completely recanalization rate. All cases had no pulmonary embolism and severe bleeding complications. Two patients relapsed during the follow-up period, all with low muscle strength. Conclusion In patients with cerebral infarction complicated by deep venous thrombosis of lower extremities, catheter thrombolysis is safe and effective. Lower limb strength is easy to relapse, pay attention to follow-up.