急性肠系膜上动脉栓塞经皮动脉长鞘抽吸去栓的实验研究  

Percutaneous aspiration thrombectomy for acute mesenteric arterial embolism:an experimental study in dogs

作　　者：马永强[1] 杨宁[2] 张晓峰[3] 陆军良[4] 

机构地区：[1]北京大学第三医院放射科,100191 [2]北京协和医院放射科 [3]北京妇产医院放射科 [4]北京军区总医院放射科

出　　处：《介入放射学杂志》2012年第2期144-147,共4页Journal of Interventional Radiology

摘　　要：目的探讨急性肠系膜上动脉栓塞后经皮抽吸去栓的安全性和可行性。方法选择杂种犬12只,采用动脉长鞘推注自体血栓法建立急性肠系膜上动脉栓塞动物模型,按取栓时间(2、4、6 h)分成3组,每组各4只,分别于栓塞后2、4、6 h用8 F动脉长鞘采用经皮抽吸去栓术进行去栓。结果各组实验动物均成功去栓,技术成功率为100%。3组平均取栓时间为(2.48±0.47)min,收集的血液量平均为(41.0±4.2)ml。去栓后血管造影复查发现各组肠系膜上动脉主干均显示再通,少数(<4,且不相邻)二级血管内可见血栓残留。去栓过程中及去栓后未见血管损伤、小肠出血等严重并发症出现。结论对于急性肠系膜上动脉主干栓塞,用8 F动脉长鞘经皮抽吸去栓安全、有效,而且具有费用低、操作简便的优点。Objective To discuss the safety and feasibility of percutaneous aspiration thrombectomy in treating acute mesenteric arterial embolism. Methods Acute superior mesenterie arterial embolism model was established in 12 hybrid dogs through injection of autologous blood clot via an arterial sheath. According to the removal time of the embolus （2, 4 and 6 hours）, the experimental dogs were randomly divided into three groups with 4 dogs in each group. Percutaneous aspiration thrombectomy by using an 8F arterial sheath was carried out at 2, 4 and 6 hours after embolization procedure for the dogs in 2, 4 and 6 hour groups respectively. The results were analyzed. Results Pereutaneous aspiration of the blood bolt with an 8F arterial sheath was successfully accomplished in all experimental dogs of the three groups. The technical success rate was 100%. The average time for the pefforman, e of thrombeetomy was （2.48 ± 0.47） min, and the average collected volume of the blood was （41.0 ± 4.2） ml. Angiography performed after aspiration revealed that the main stem of the superior mesenteric artery was reopened in all dogs of each group, and residual embolus was seen in a small number of second vascular branches （less than 4 vessels and not adjacent to each other）. No serious complications, such as vascular injuries or intestinal bleeding, occurred during and after the aspiration procedures. Conclusion For the treatment of acute superior mesenteric artery embolism, percutaneous aspiration thrombectomy with an 8 F arterial sheath is safe, effective, economical and technically simple.

关 键 词：肠系膜动脉栓塞 经皮抽吸去栓术 动物实验 

分 类 号：R657.2[医药卫生—外科学]