Objective: To compare the clinical efficacy differences between anterograde and retrograde catheterization interventional treatment for acute low extremity deep venous thrombosis(DVT). Methods: The clinical data of 217 patients with acute low extremity DVT between January 2009 and December 2014 were analyzed retrospectively. Group A: 67 patients underwent treated with anterograde catheterization interventional treatment. Group B: 150 patients underwent treated with retrograde catheterization interventional treatment. The degree of thrombolysis in different anatomical sites, clinical effective rate, femoral-popliteal vein valve reflux and the incidence of post-thrombotic syndrome(PTS) were all analyzed. Results: There were no statistical differences in the degree of thrombolysis (≥50%) of common iliac vein, external iliac vein and common femoral vein between group A (83.6%, 88.1%, 91.0%)and B (80.7%, 82.0%, 88.0%)(all P>0.05). The degree of thrombolysis (≥50%) of superficial femoral vein in group A(94.0%) was significantly higher than that of group B (75.3%)(P=0.001). There was no significantly difference in the clinical effective rate at discharged between group A (80.6%) and B(76.7%)( P=0.519). During follow-up of 44±15 months, There was no statistical difference in the patency rate of the iliofemoral vein, the valvular regurgitation of patent femoropopliteal vein and the incidence of PTS between group A(70.2%, 25.4%, 35.8%) and B (60.0%, 31.5%, 40.0%)(all P>0.05). The incidence of PTS in patients with iliofemoral vein patency(13.1%) was significantly lower than that in patients with iliofemoral vein occlusion (82.5%)(P<0.01). Conclusions: The anterograde or retrograde catheterization interventional treatment can be used for treating acute low extremity DVT and get comparable clinical effect.The retrograde catheterization does not increase venous valve damage. The recovery of iliofemoral vein lumen patency is the main task in the treatment of DVT and can significantly reduce the incidence of PTS.
目的： 比较顺行和逆行插管途径介入治疗急性下肢深静脉血栓形成(DVT)的临床疗效。 方法： 回顾性分析2009年1月至2014年12月南京医科大学附属南京医院介入科采用顺行(A组)或逆行(B组)插管途径介入治疗急性下肢DVT患者217例，A组67例、B组150例。对两组不同解剖部位的静脉血栓溶解程度、临床有效率、股腘静脉瓣膜反流及血栓形成后综合征(PTS)发生率等方面进行对比分析。 结果： 髂总静脉、髂外静脉、股总静脉的血栓溶解程度(≥50%)，A组(83.6%、88.1%、91.0%)与B组(80.7%、82.0%、88.0%)比较，差异均无统计学意义(均P>0.05)。股浅静脉血栓溶解程度(≥50%)，A组(94.0%)明显优于B组(75.3%)，差异有统计学意义(P＝0.001)。出院时临床有效率，A组(80.6%)与B组(76.7%)比较，差异无统计学意义(P＝0.60)。平均随访(44±15)个月，髂股静脉主干通畅率、股腘静脉开通的患者中静脉瓣膜反流率及血栓形成后综合征(PTS)的发生率，A组(70.2%、25.4%、35.8%)与B组(60.0%、31.5%、40.0%)比较，差异均无统计学意义(均P>0.05)。髂股静脉管腔通畅的患者中PTS的发生率13.1%明显低于髂股静脉管腔闭塞的患者82.5%，差异有统计学意义(P<0.01)。 结论： 顺行和逆行插管途径介入治疗急性下肢DVT可以获得类似的临床效果，逆行插管没有增加静脉瓣膜的损伤，恢复髂股静脉管腔的通畅是治疗DVT的主要任务，可以明显降低PTS的发生率。.
Keywords: Catheterization; Comparative study; Venous thrombosis.