李俊 1司小毛 1查斌山 1谢文涛 1仇鹏 1朱化刚1
作者信息
- 1. 安徽医科大学第一附属医院血管外科 230032
- 折叠
摘要
Abstract
Objective To compare the clinical efficacy of catheter directed thrombolysis(CDT ) ,thrombectomy(ST ) and system‐atic anticoagulant(SA) in treating acute iliofemoral deep vein thrombosis(AIFDVT ) of lower limb using Meta analysis method . Methods The systematic review was initialted by electronic literature searches (PUBMED ,MEDLINE ,ELSEVIER ,etc .) for stud‐ies comparing catheter directed thrombolysis ,thrombectomy and systematic anticoagulant clinical effects published from January 1984 to January 2014 based on the keyword such as "iliofemoral deep vein thrombosis;thrombolysis;anticoagulant therapy ;throm‐bectomy ;RCTs;Meta analysis".A Meta analysis was conducted to estimate early vein patency ,post thrombotic syndrome(PTS) , venous reflux(VR) rate ,venous obstruction(VO) rate ,etc .Results Ten RCTs were included in this analysis ,including 626 pa‐tients .The early vein patency rate was higher in the CDT group and the difference was statistically significant(OR=4 .61 ,95% CI 1 .93-10 .98 ,P<0 .05);there was no statistically difference between ST and SA group(OR= 2 .54 ,95% CI 0 .49 -13 .24 ,P>0 .05) .The post thrombotic syndrome rate was less both in the CDT group(OR=0 .18 ,95% CI 0 .07 -0 .43 ,P< 0 .05) and ST group(OR=0 .50 ,95% CI 0 .28 -0 .87 ,P< 0 .05);the difference was statistically significant .The difference of the venous reflux rate was not statistically significant in both two groups .The venous obstruction rate was less in the CDT group(OR=0 .19 ,95% CI 0 .11-0 .34 ,P<0 .05) and the difference was statistically significant ;while the difference was not statistically significant between ST and SA group (OR=1 .53 ,95% CI 0 .72-3 .26 ,P>0 .05) .Conclusion For acute iliofemoral deep vein thrombosis(AIFDVT) , short term (< 7 d) outcomes of catheter directed thrombolysis was better than anticoagulant therapy ,but thrombolysis brought more bleeding .In long term(>6 m) outcomes ,the post thrombotic syndrome rate was less both in the thrombolysis group and the thrombectomy ,and catheter directed thrombolysis could diminish the vein obstruction rate .关键词
M eta分析/髂股静脉/抗凝/置管溶栓/血栓切除术Key words
Meta analysis/iliofemoral deep vein thrombosis/thrombolysis/anticoagulant therapy/thrombectomy分类
医药卫生
