超声造影在下肢深静脉血栓介入性治疗中的应用价值  

Application value of contrast-enhanced ultrasound in interventional treatment of lower limb deep venous thrombosis

作　　者：朱贤胜[1] 王莎莎[1] 王俊[2] 彭小波[2] 贺冬莲[1] 

机构地区：[1]广州军区广州总医院超声影像科,广州市510010 [2]广州军区广州总医院超声影像科心脏外科,广州市510010

出　　处：《临床超声医学杂志》2011年第9期606-608,共3页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨超声造影在下肢深静脉血栓介入性治疗中的应用价值。方法下肢深静脉血栓形成患者37例,在超声引导下经腘静脉穿刺置入溶栓导管至髂总静脉内,再通过溶栓导管注入稀释的超声造影剂,观察导管头端的准确位置及调整导管进入的深度,使导管头端达下腔静脉内再经X线静脉造影检查置管的位置。而后以100～150万U/疗程微注泵持续推注尿激酶,每3天再次行导管超声造影,观察溶栓导管侧孔处溢出造影剂在血管内分布状况以判断溶栓的效果。结果 2例患者因血栓形成时间较长,溶栓导管无法置入;35例患者在超声引导下顺利置入溶栓导管,与X线造影对照,超声造影准确指导调节34例患者溶栓导管放至适当的位置。35例患者溶栓治疗平均时间7d,溶栓后症状明显改善,下肢肿胀消退,无严重并发症。结论超声造影能准确指导调节溶栓导管的放置位置,且能准确评价溶栓治疗效果。Objective To explore the application value of contrast-enhanced ultrasound （CEUS） in interventional treatment of lower limb deep venous thrombosis. Methods Ultrasound - guided percutaneous popliteal vein puncture and insertion of thrombolysis catheter to common iliac vein were performed in 37 patients with lower limb deep venous thrombosis. Contrast agents were infused into the thrombolysis catheter, the location of the catheter was observed and adjusted to the inferior vena cava（IVC）. The catheter location was further examined by X -ray. Urokinase was infused to dissolve the thrombus. CEUS was applied every 3 days. The distribution of contrast agents in the vein and the thrombolysis effect were observed. Results The thrombolysis catheter couldn＇t be sucessfully inserted to common iliac vein in 2 cases, thrombolysis catheter was sucessfully inserted to common iliac vein by ultrasound guidance in 35 cases. Compared with X - ray , the thrombolysis catheter location was corrected in 34 patients with the guidance of CEUS. The average thrombolysis time was 7 d in 35 cases. Symptoms were significantly improved, swelling of the limbs was reduced and no complication happened. Conclusion CEUS can adjust the location of thrombolysis catheter accurately, and it also can evaluate the therapeutic efficacy.

关 键 词：超声检查 造影剂 下肢深静脉血栓 介入性治疗 

分 类 号：R743[医药卫生—神经病学与精神病学]