摘要
目的探讨血管缝合器完全穿刺技术缝合股动脉在主动脉腔内隔绝术中的应用价值及其安全性.方法回顾性分析2010年1月至2013年11月昆明医科大学附属延安医院血管外科184例行“主动脉腔内隔绝术”患者的临床资料,使用血管缝合器缝合穿刺股动脉,观察其止血效果.结果 184例患者术中穿刺缝合单侧股动脉127例,术中穿刺缝合双侧股动脉57例,术中一侧股动脉使用2把血管缝合器184例,缝合器缝合完毕后立即停止出血170条,压迫5 min止血13条,压迫10 min止血1条,成功率100%,术中使用1把缝合器缝合完毕后立即停止出血51条,压迫5 min止血5条,压迫10 min止血1条,成功率100%,预埋1把血管缝合器时间为1.5 min,术后缝合推结时间1 min.术中无一条中转切开缝合,6条术后出现血肿,未治疗约2周后消退.术后随访3～36个月.3条动脉下肢疼痛经血管彩超或CTA检查证实有股动脉轻中度狭窄,经对症治疗后好转.结论使用血管缝合器完全穿刺技术在主动腔内隔绝术中的应用是安全有效的,值得临床推广应用.
Objective To investigate the application value and safety of total percutaneous technology with blood vessel suture instrument to suture femoral artery in the aortic Endovascular Graft Exclusion. Methods We retrospectively analyzed 184 cases of Endovascular Graft Exclusion for treating aortic disease in Affiliated Yan＇an Hospital of Kunming Medical University from Jan. 2010 to November 2014. Blood vessel suture instument was used to stitch the punctured femoral artery after surgery, and the hemostatic effect was evaluated. Results Among 184 cases of artery uture, there were 127 cases of unilateral femoral artery suture and 57 cases of bilateral femoral artery suture. 184 cases used 2 blood vessel suture instruments in the unilateral femoral artery suture, 386 blood vessel suture instruments were used. 241 femoral artery branches were stitched by blood vessel suture instruments, and for those used 2 blood vessel suture instruments, 170 of them stopped bleeding immediately, 13 of them stopped bleeding after oppression for 5 rains, and 1 of them stopped bleeding after oppression for I0 mins, the success rate was 100% ; and for those only use 1 blood vessel suture instruments, 51 of them stopped bleeding immediately, 5 of them stopped bleeding after oppression for 5 mins, and 1 of them stopped bleeding after oppression for 10 rains, the success rate was 100%. Embedding 1 blood vessel suture instrument took 1.5 min, postoperative suture knot took 1 rain.For thoracic aortic dissection and thoracic aortic aneurysms, unilateral formal artery was punctured and 2 suture instruments were used, for abdominal aortic aneurysm and abdominal aortic dissection, bilateral formal arteries were punctured and 2 suture instruments were used for the major artery and 1 was used for the minor artery;because of close distance to iliac artery bifurcation, all 3 cases of bilateral iliac artery aneurysms used 3 suture instruments. There was no incision suture in operation, hematoma appeared in 6 cases and disappeared without treatment after 2 weeks. All patients were followed up for 3 to 36 months. 3 cases of artery lower limb pain had mild-to-moderate stricture of formal artery confirmed by vascular corlor ultrasound or CTA examination, and recovered after symptomatic treatment. Conclusion Total percutaneous technology with blood vessel suture instrument in the aortic Endovascular Graft Exclusion is safe and effective, and worthy of clinical promotion.
出处
《昆明医科大学学报》
CAS
2015年第5期79-81,共3页
Journal of Kunming Medical University
基金
云南省科技厅科技惠民专项基金资助项目(2014RA071)
关键词
完全穿刺技术
主动脉腔内隔绝术
应用价值
Total percutaneous technology
Aortic endovascular graft exclusion
Application value
