超声引导下注射血小板胶治疗股动脉假性动脉瘤的临床研究  

Ultrasound-guided injection of autologous platelet gel for the treatment of femoral artery pseudoaneurysm

作　　者：聂树涛[1] 孙志民[2] 

机构地区：[1]潍坊医学院附属齐鲁石化医院集团中心医院血库,山东淄博255400 [2]潍坊医学院附属齐鲁石化医院集团中心医院超声科,山东淄博255400

出　　处：《解放军医学杂志》2008年第8期1025-1027,共3页Medical Journal of Chinese People's Liberation Army

摘　　要：目的评价超声引导下瘤腔内注射血小板胶治疗医源性假性动脉瘤的临床应用价值。方法冠状动脉介入诊治术后股动脉假性动脉瘤患者19例,其中单个瘤囊者18例,另1例存在3个瘤囊。在超声引导下穿刺假性动脉瘤瘤腔并注射2ml血小板胶行封闭治疗,所有病例均在治疗后24h和3～5d复查超声。并在注射血小板胶前及注射后48h检测血小板计数(PLT)、凝血功能指标[凝血酶原时间(PT),活化部分凝血活酶时间(APTT),凝血酶时间(TT),纤维蛋白原(Fib)]、血液流变学指标(全血高切黏度,全血低切黏度,全血高切还原黏度,全血低切还原黏度,血浆黏度,RBC刚性指数,RBC聚集指数)和D-二聚体。结果14例患者在瘤囊内注入血小板胶后瘤腔即刻闭合,5例患者动脉与瘤腔通道血流明显减弱,在超声指引下压迫5～10min闭合,治愈率100%,无并发症发生。所有病例24h及3～5d后复查无复发;所有病例注射血小板胶前后PLT、凝血功能、血液流变学和D-二聚体比较无显著性差异(P>0.05)。结论超声引导下注射血小板胶简便、安全、有效,可作为临床治疗假性动脉瘤的方法之一。Objective To evaluate the therapeutic efficacy and safety of ultrasound-guided autologous platelet gel（APG）injection for the treatment of femoral artery pseudoaneurysm.Methods The present study involved 19 patients who had undergone percutaneous coronary interventional therapy and complicated with femoral artery pseudoaneurysm.One pseudoaneurysm occurred in 18 patients,while 3 pseudoaneurysms were found in one patient.Under the guidance of ultrasound,APG（made of concentrated platelet,200U thrombin,and 0.01mol/L calcium）was directly injected in a dose of 2ml into the sac of femoral artery pseudoaneurysm.All the patients underwent ultrasound examination at 24h and day 3,4 and 5 after treatment.The following items were analyzed before and 48h after APG injection：platelet count,prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,fibrinogen（Fib）,hemorheology and D-dimer.Data were expressed as x±s,and Students＇ t test was used in comparison between the two groups.Results After injection of APG,pseudoaneurysm sacs were immediately closed in 14 patients,and blood flow from the artery to the sacs was significantly decreased in the other 5 patients and the sacs were finally closed 5-10 minutes after pressing.The overall cure rate was 100% without complications.No recurrence was found at 24h and day 3,4 and 5 after APG injection,and no statistically significant changes were found in the examined parameters（platelet counting,PT,APTT,TT,Fib,hemorheology and D-dimer）before and after the treatment（P〉0.05）.Conclusion Ultrasound-guided injection of APG is one of the easy,safe,and effective methods for femoral artery pseudoaneurysm.

关 键 词：超声检查 介入性 血小板胶 动脉瘤 假性 

分 类 号：R654.3[医药卫生—外科学]