摘要
目的观察AngioJet经皮机械血栓清除术(PMT)治疗外科手术后急性下肢深静脉血栓(DVT)的效果。方法回顾性分析103例接受AngioJet PMT治疗的外科手术后急性下肢DVT患者,对比术前与术后7天大腿和小腿患-健侧周径差及外周血D-二聚体水平,检测下肢静脉各段血栓清除率,记录术中及术后不良反应。结果PMT后7天,大腿和小腿患-健侧周径差均较术前减小(P均<0.05),外周血D-二聚体较术前下降(P<0.05);下肢静脉髂段、股段及腘段有效(Ⅱ、Ⅲ级)血栓清除率分别为97.37%(74/76)、98.06%(101/103)及94.83%(55/58),Ⅲ级血栓清除率分别为77.63%(59/76)、70.87%(73/103)和55.17%(32/58),髂段、股段Ⅲ级血栓清除率均高于腘段(P均<0.01)。血栓清除术中11例(11/103,10.68%)出现一过性心律失常,均于停止吸栓操作2 min内恢复正常。术后3例发生穿刺点出血,一过性血红蛋白尿38例,一过性肌酐升高2例,患肢疼痛3例;未见新发肺栓塞和急性肾衰竭。2例滤器未取出;6例取出滤器内见明显血栓。结论AngioJet机械血栓清除术治疗急性下肢DVT效果较好且安全。
Objective To evaluate the effect of percutaneous mechanical aspiration thrombectomy(PMT)with AngioJet for treatment of acute deep venous thrombosis(DVT)after surgical operation.Methods Data of 103 patients with acute lower extremity DVT after surgical operation who underwent AngioJet PMT were retrospectively analyzed.The affected-healthy side diameter differences of thigh and leg,as well as peripheral blood D-dimer levels were compared before and 7 days after AngioJet PMT.The clearance rate of thrombosis for each segment of lower limb veins was detected,the intraoperative and postoperative adverse reactions were counted.Results Seven days after AngioJet PMT,both the affected-healthy side diameter difference of thigh and leg decreased,so did the peripheral blood D-dimer value(all P<0.05).Effective thrombosis clearance rate(gradeⅡ,Ⅲ)of iliac vein,femoral vein and popliteal vein was 97.37%(74/76),98.06%(101/103)and 94.83%(55/58),respectively,while gradeⅢclearance rate of the above segments was 77.63%(59/76),70.87%(73/103)and 55.17%(32/58),respectively,of iliac vein and femoral vein were all higher than that of popliteal vein(both P<0.01).Transient arrhythmia occurred in 11 cases(11/103,10.68%)during thrombectomy,and returned to normal within 2 min after stopping thrombectomy.Hemorrhage at the puncture site occurred in 3 cases,while 38 cases were found with transient hemoglobinuria,2 cases with transient creatinine elevation and 3 cases with limb pain.No new pulmonary embolism nor acute renal failure occurred.The filters were failed to be removed in 2 cases,while removed filters were found with obvious thrombi in 6 cases.Conclusion Percutaneous mechanical aspiration thrombectomy with AngioJet was effective and safe for treatment of acute lower extremity DVT.
作者
田磊
魏俊成
卢卫航
王世华
张朝军
杨坤秋
TIAN Lei;WEI Juncheng;LU Weihang;WANG Shihua;ZHANG Chaojun;YANG Kunqiu(Health Science Center of General Surgery,the First Medical Center of PLA General Hospital,Beijing 100048,China)
出处
《中国介入影像与治疗学》
北大核心
2020年第10期600-603,共4页
Chinese Journal of Interventional Imaging and Therapy
关键词
静脉血栓形成
下肢
腔静脉滤器
血管造影术
数字减影
venous thrombosis
lower extremity
vena cava filters
angiography,digital subtraction
