摘要
目的 :了解超声引导下注射凝血酶 (UGTI)治疗医源性股动脉假性动脉瘤 (PS)对机体凝血指标的影响 ,评价超声引导下注射凝血酶治疗PS的可行性。方法 :15例经股动脉径路选择性冠状动脉 (冠脉 )造影和冠脉介入术后医源性股动脉PS患者接受了超声引导下注射凝血酶治疗。男性 5例 ,女性 10例 ,平均年龄 (68 5± 12 0 )岁 ,选择性冠脉造影 1例 ,经皮冠脉介入 14例。单腔的单纯型PS 9例 ,2腔或 3腔的复杂型PS 6例。分析PS接受凝血酶治疗剂量、治疗结果以及机体凝血指标。注射凝血酶前、注射凝血酶后 2 4小时、注射凝血酶后 5～ 7天测定了以下指标 :血小板计数、红细胞压积、血红蛋白、活化的凝血激酶时间、凝血酶原时间、凝血酶时间、纤维蛋白原及二维超声心动图检查。结果 :共注射凝血酶 2 1次 ,平均每次注射凝血酶剂量 ,单腔为 (186± 12 0 )IU ,双腔或多腔为 (3 88± 15 0 )IU。 9例单纯型PS患者全部一次成功 ;6例双腔或多腔的复杂型PS患者 4例一次成功 ,2例复杂型PS患者出现“再通” ,经重复注射凝血酶后 ,封闭成功。无一例出现其他部位血栓形成、感染、过敏等并发症。注射凝血酶前后 ,机体各项凝血指标间相比无显著差异。结论 :超声引导下注射凝血酶治疗股动脉PS安全有效 ,PS瘤腔内局部注射凝血酶对机体凝?
Objective: To evaluate the feasibility and influence in systemic coagulation of ultrasound guided thrombin injection(UGTI)in the treatment of iatrogenic pseudoaneurysms(PS). Methods: Fifteen iatrogenic pseudoaneurysm patients following femoral arterial puncture for coronary arterial angiography and Percutaneous coronary intervention(PCI)were treated with UGTI. Coronary arterial angiography in one and PCI in 14 were performed (5 males and 10 females,mean age 68.5±12.0 years ). There were 9 simple PS patients with one lobe and 6 patients complex PS with two or three lobes. Thrombin dose,outcome,systemic coagulatlon parameters were analysised.PLT,HGB,HCT,PT,APTT,TT,Fg,two-dimensional sonography were performed before,and 24 hours and 5-7days after UGTI. Results: Mean volume of PS was 13.00±4.89 cm 3. Twenty-one thrombin injections were performed. Mean thrombin dose was 250±120 IU in simple and 650±150 IU in complex PS. Primary success was achieved in 9 simple and 4 of 6 complex PS. Reperfusion occurring in two complex PS was completely obliterated after repeated thrombin injections. No thromboembolic,infectious,allergic complications occurred. No marked difference was noted among systemic coagulation parameters. Conclusions: UGTI is a safe and effective therapy for iatrogenic pseudoaneurysms following femoral arterial puncture for PCI. No significant effect was detected on systemic coagulation of UGTI.
出处
《中国循环杂志》
CSCD
北大核心
2004年第2期117-119,共3页
Chinese Circulation Journal
