置管溶栓治疗下腔静脉血栓：附21例报道

doi:10.3877/cma.j.issn.2095-5782.2020.03.010

中华介入放射学电子杂志 ›› 2020, Vol. 08 ›› Issue (03) : 240 -243. doi: 10.3877/cma.j.issn.2095-5782.2020.03.010

所属专题：经典病例；经典病例；文献；

血管介入

置管溶栓治疗下腔静脉血栓：附21例报道

顾晓诚¹, 李绍钦¹, 王凯¹, 田丰¹, 贾中芝¹^,^†(

)

^1. 213003　江苏常州，常州市第二人民医院介入血管科

收稿日期:2020-04-02 出版日期:2020-08-25
通信作者: 贾中芝
基金资助:
江苏省医院管理创新研究课题(JSYGY-3-2019-451)

Catheter-directed thrombolysis in the treatment of inferior vena cava thrombus: A report of 21 cases

Xiaocheng Gu¹, Shaoqin Li¹, Kai Wang¹, Feng Tian¹, Zhongzhi Jia¹^,^†()

^1. Department of Interventional Radiology, Changzhou No. 2 People's Hospital, Jiangsu Changzhou 213003, China

Received:2020-04-02 Published:2020-08-25
Corresponding author: Zhongzhi Jia
About author:
Corresponding author: Jia Zhongzhi, Email: jiazhongzhi.1998@163.com

全文 ( ) 下载PDF ( ) 导出引用

目的

探讨置管溶栓（catheter-directed thrombolysis，CDT）治疗下腔静脉血栓的安全性和疗效。

方法

回顾性分析21例经CDT治疗的下腔静脉血栓患者的临床及影像资料。

结果

21例患者均经静脉造影诊断为下腔静脉血栓，同时伴有下肢深静脉血栓。其中下肢深静脉血栓向上延续导致的下腔静脉血栓18例，下腔静脉滤器导致的下腔静脉血栓3例。21例患者均在下腔静脉滤器的保护下成功进行CDT治疗，其中7例患者伴有髂静脉压迫综合征，给予髂静脉支架治疗。随访3～48个月，1例肿瘤患者CDT术后2周再次出现下肢深静脉血栓，给予加强抗凝治疗后好转，其他患者无血栓复发，所有患者无严重并发症的发生。

结论

下肢深静脉血栓和下腔静脉滤器均会导致下腔静脉血栓。在下腔静脉滤器的保护下，CDT治疗下腔静脉血栓是安全有效的方法。

关键词: 下腔静脉, 血栓, 尿激酶, 治疗

Objective

To investigate the safety and effectiveness of catheter-directed thrombolysis (CDT) in the treatment of inferior vena cava (IVC) thrombus.

Methods

The clinical data and imaging features of 21 patients with IVC thrombus underwent CDT therapy were analyzed retrospectively.

Results

A total of 21 patients with lower limb deep vein thrombosis (DVT) were diagnosed as IVC thrombus by venography. The reasons of IVC thrombus were lower limb DVT in 18 cases and IVC filter in 3 cases. CDT was performed successfully under the protection of IVC filter in all cases, besides, 7 of them underwent stent placement for iliac vein compression syndrome. During 3-48 months of follow-up, recurrence of lower limb DVT occured in one patient with cancer two weeks after treatment, and improved after anticoagulation therapy. There were no serious complications.

Conclusions

Both of IVC filter and lower limb DVT can cause IVC thrombus. CDT is a safe and effective treatment for IVC thrombus.

Key words: Inferior vena cava, Thrombus, Urokinase, Treatment

图1 58岁女性患者，因"左下肢肿胀4 d"入院，下肢深静脉造影诊断为：左下肢DVT，伴IVC血栓，血栓范围为左侧髂外静脉、髂总静脉及IVC

[1]	Carvalho DZ, Hughes JD, Liebo GB, et al. Venous congestive myelopathy due to chronic inferior vena cava thrombosis treated with endovascular stenting: Case report and review of the literature[J]. J Vasc Interv Neurol, 2015, 8(1): 49-53.
[2]	董典宁，吴学君，张十一，等．急性下肢深静脉血栓形成合并下腔静脉血栓的临床诊疗[J]．中华医学杂志，2013, 93(21): 1611-1614.
[3]	蒋鹏，刘建龙，贾伟，等．骨科患者下肢深静脉血栓脱落致肺动脉栓塞诱因分析[J]．中华医学杂志，2012, 92(45): 3224-3226.
[4]	Nagarsheth KH, Sticco C, Aparajita R, et al. Catheter-directed therapy is safe and effective for the management of acute inferior vena cava thrombosis[J]. Ann Vasc Surg, 2015, 29(7): 1373-1379.
[5]	Kishima H, Fukunaga M, Nishian K, et al. Aspiration thrombectomy in a patient with suprarenal inferior vena cava thrombosis[J]. Case Rep Cardiol, 2015, DOI: 10.1155/2015/495065.
[6]	Vinod KV, Arun K, Nisar KK, et al. Inferior vena caval thrombosis: A rare complication of acute pancreatitis[J]. J Assoc Physicians India, 2014, 62(5): 430-432.
[7]	Kraft C, Schuettfort G, Weil Y, et al. Thrombosis of the inferior vena cava and malignant disease[J]. Thromb Res, 2014, 134(3): 668-673.
[8]	Sun J, Zhang Q, Xu H, et al. Clinical outcomes of warfarin anticoagulation after balloon dilation alone for the treatment of Budd-Chiari syndrome complicated by old inferior vena cava thrombosis[J]. Ann Vasc Surg, 2014, 28(8): 1862-1868.

[1]	史学兵, 谢迎东, 谢霓, 徐超丽, 杨斌, 孙帼. 声辐射力弹性成像对不可切除肝细胞癌门静脉癌栓患者放射治疗效果的评价[J/OL]. 中华医学超声杂志（电子版）, 2024, 21(08): 778-784.
[2]	李华志, 曹广, 刘殿刚, 张雅静. 不同入路下行肝切除术治疗原发性肝细胞癌的临床对比[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 52-55.
[3]	陈浩, 王萌. 胃印戒细胞癌的临床病理特征及治疗选择的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 108-111.
[4]	许月芳, 刘旺, 曾妙甜, 郭宇姝. 多粘菌素B和多粘菌素E治疗外科多重耐药菌感染临床疗效及安全性分析[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 700-703.
[5]	刘柏隆, 周祥福. 压力性尿失禁阶梯治疗的项目介绍[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 125-125.
[6]	刘柏隆. 女性压力性尿失禁阶梯治疗之手术治疗方案选择[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(01): 126-126.
[7]	公宇, 廖媛, 尚梅. 肝细胞癌TACE术后复发影响因素及预测模型建立[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 818-824.
[8]	李一帆, 朱帝文, 任伟新, 鲍应军, 顾俊鹏, 张海潇, 曹耿飞, 阿斯哈尔·哈斯木, 纪卫政. 血GP73水平在原发性肝癌TACE疗效评价中的作用[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 825-830.
[9]	魏志鸿, 刘建勇, 吴小雅, 杨芳, 吕立志, 江艺, 蔡秋程. 肝移植术后急性移植物抗宿主病的诊治（附四例报告）[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 846-851.
[10]	吴天宇, 刘子璇, 杨浦鑫, 贾思明, 丁凯, 程晓东, 李泳龙, 陈伟, 吕红芝, 张奇. 腰椎间盘突出症保守治疗进展[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 379-384.
[11]	于洁, 金小红, 顾艳楣, 王慧, 葛杨杨, 李燕. 癌症相关静脉血栓栓塞症患者疾病体验与需求的质性研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 739-744.
[12]	崔军威, 蔡华丽, 胡艺冰, 胡慧. 亚甲蓝联合金属定位夹及定位钩针标记在乳腺癌辅助化疗后评估腋窝转移淋巴结的临床应用价值探究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 625-632.
[13]	王誉英, 刘世伟, 王睿, 曾娅玲, 涂禧慧, 张蒲蓉. 老年乳腺癌新辅助治疗病理完全缓解的预测因素分析[J/OL]. 中华临床医师杂志(电子版), 2024, 18(07): 641-646.
[14]	张平骥, 徐钰, 李天水, 庞文翼, 符师宁, 张梦圆. 重症患者镇静治疗现状及期望的调查研究[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 562-567.
[15]	王昌前, 林婷婷, 宁雨露, 王颖杰, 谭文勇. 光免疫治疗在肿瘤领域的临床应用新进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(06): 575-583.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Catheter-directed thrombolysis in the treatment of inferior vena cava thrombus: A report of 21 cases

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Catheter-directed thrombolysis in the treatment of inferior vena cava thrombus: A report of 21 cases