Objective To summarize the early and medium-term efficacies of thrombectomy and catheter-directed thrombolysis (CDT) in the treatment of acute lower extremity deep vein thrombosis (DVT). Methods From June 2009 to May 2012, clinical data of 40 cases with acute lower extremity DVT were analyzed retrospectively. Thrombectomy plus extrusion of lower extremity, CDT and anticoagulant therapy alone were adopted respectively. The early and medium-term efficacies were evaluated by venous patency score, venous patency rate and the improvement of clinical symptoms. Results The venous patency score improved significantly in the thrombectomy group (7 cases with central DVT) and the CDT group (19 cases with mixed DVT) at 1 week after surgery(P<0.01). And the venous patency rate was (76.46±11.42)%and (69.17±8.79)%, respectively. There were significant differences in the circumferences of lower limb at 10cm above and below the knee at 1 week before and after surgery (P<0.01). In anticoagulant therapy group (14 cases with peripheral DVT), the venous patency rate was (56.09±4.23) %. There were no significant differences in the venous patency score and the circumferences of lower limb at 10cm above and below the knee at 1 week before and after treatment (P>0.05). Thirty-three cases were followed up for 1~24 months. During the follow-up, for 24 cases treated by thrombectomy and CDT, limb swelling completely alleviated, and no recurrences and ulcerations occurred. For 9 cases treated by anticoagulant therapy, slightly limb swelling, the superficial vein dilatation and mild pigmentation appeared in 6 cases. But limb swelling subsided slightly, leg ulceration and pigmentation appeared in other 3 cases. Conclusion Thrombectomy or CDT can rapidly improve the venous reflux disorders in the treatment of acute lower extremity DVT. It has safety, feasibility, remarkable early and medium-term efficacy.%目的：总结手术取栓与导管直接溶栓（CDT）治疗急性下肢深静脉血栓形成（DVT）的早、中期疗效。方法回顾性分析2009年6月~2012年5月期间收治的40例急性下肢DVT患者的临床资料，分别采用股静脉切开取栓+下肢挤压驱栓、CDT治疗及单纯抗凝治疗。通过静脉通畅评分、静脉通畅率及临床症状改善情况评价其早、中期疗效。结果7例中央型血栓（股青肿）患者行股静脉切开取栓术及19例混合型血栓患者行CDT治疗，术后1周患者静脉通畅评分均较术前显著改善（P<0.01），静脉通畅率分别为（76.46±11.42）%及（69.17±8.79）%；其术前、术后1周膝上、膝下10 cm周径差比较，差异均有统计学意义（P<0.01）。14例周围型血栓患者行保守治疗，静脉通畅率为（56.09±4.23）%。治疗前、后1周静脉通畅评分及治疗前、后1周膝上、膝下10 cm周径差比较，差异无统计学意义（P>0.05）。33例患者获得随访，随访时间1~24个月。24例股静脉切开取栓及CDT治疗患者在随访期间，肢体肿胀完全消退，下肢深静脉主干通畅，无溃疡形成。9例保守治疗患者在随访期间，有6例肢体轻微肿胀伴浅表静脉扩张，轻度色素沉着；3例肢体肿胀稍消退，出现小腿溃疡及色素沉着。结论手术取栓或CDT治疗急性下肢DVT能迅速改善静脉回流障碍，早、中期疗效显著，安全可行。
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