超声消融在治疗慢性深静脉血栓形成中的作用  

Ultrasonic ablation in chronic deep vein thrombosis of lower extremities

作　　者：王爱林[1] 靖冬梅[1] 韩圣辉[1] 刘军[1] 刘丽[1] 

机构地区：[1]哈尔滨黑龙江省医院周围血管病科,150001

出　　处：《介入放射学杂志》2005年第5期490-492,共3页Journal of Interventional Radiology

摘　　要：目的评价超声消融在治疗慢性下肢深静脉血栓形成中的作用。方法56例慢性深静脉血栓患者接受了静脉内超声消融治疗,超声消融时间为12～24min,平均18min,术后深静脉内导管抗凝,在小腿应用静脉趋动器促进血液回流。对其中18例患者安放内支架。结果56例髂股静脉闭塞中49例完全再通(87.5%),5例部分再通(8.9%)。2例未再通(3.6%)。49例完全再通者随访38例,22例未安放支架者,9例发生再闭塞,达40.9%;16例安放支架患者中2例发生再闭塞,再闭塞12.5%。结论超声消融可以再通已经闭塞的髂股静脉血栓形成并为进一步进行球囊扩张和安放内支架创造了条件,同时超声消融结合腔内支架治疗可提高慢性深静脉血栓形成患者治疗后的长期通畅率。Objective To evaluate the clinical efficacy of ultrasonic ablation in patients with chronic deep vein thrombosis of lower extremities. Methods Fifty-six patients with chronic deep vein thrombosis resulting in total occlusion of iliae-femoral veins accepted intra-venous ultrasonic ablation. The time for ultrasonic ablation was 12-24 minutes with the mean being 18 minutes. After the procedure, anti-coagulation was performed through the retaining catheters and venous propeller was utilized for promoting blood reflow. Results Ultrasonic ablation easily created a channel within the occlusive lilac-femoral veins and achieved successful recanalization in 49 of 56 patients （87.5%）. Five patients （8.9%） were partially re-canalized and 2 （3.6%） had no recanalization. Thirty-eight of the 49 re-canalized patients were followed up, including 22 with no stent placement showed 9 （40.9%） re-occlusion and 16 received stent placement, and 2 had （12.5%） re-occlusion. Conclusions Intravascular ultrasonic ablation is an effective therapeutic modality to recanalize chronic thrombosed occlusion of iliac-femoral veins and can lay down a foundation for further balloon-expansiou or stent-placement with long term patency.

关 键 词：超声消融 慢性血栓形成 内支架 慢性下肢深静脉血栓形成 超声消融治疗 髂股静脉血栓形成 腔内支架治疗 慢性深静脉血栓 静脉闭塞 长期通畅率 血液回流 球囊扩张 

分 类 号：R543.6[医药卫生—心血管疾病] R654.4[医药卫生—内科学]