Fine-flow在超声引导下注射凝血酶治疗假性动脉瘤中的价值  

Value of Fine-flow in ultrasound-guided thrombin injection for treatment of femoral artery pseudoaneurysms

作　　者：付赤学[1] 刘贵伦[1] 胡安惠[1] 

机构地区：[1]武警重庆市总队医院超声科,重庆400061

出　　处：《生物医学工程与临床》2013年第5期439-442,共4页Biomedical Engineering and Clinical Medicine

基　　金：国家自然科学基金资助项目(30901389)

摘　　要：目的 探讨Fine-flow技术在超声引导下注射凝血酶治疗股动脉假性动脉瘤（PSA ）中的临床应用价值。方法 29例股动脉PSA患者，其中男性21例，女性8例；年龄51 ～ 69岁，平均年龄63.27岁。超声引导下穿刺注入凝血酶，术前行彩色多普勒超声及Fine-flow技术测量瘤腔的大小、瘤颈的长度及宽度，术后测量血栓体积，并用Fine-flow技术检测封堵效果及并发症。结果 29例PSA术前经灰阶超声联合Fine-flow技术确诊，其中23例为单纯型，6例为复杂型；23例单纯型及4例复杂型均一次性封堵成功，2例复杂型PSA于第2天复发，行再次封堵成功。彩色多普勒超声测量瘤腔体积为（6.2 ± 2.3）cm3，瘤颈长（4.3 ± 1.3）mm、宽（2.3 ± 0.9） mm。Fine-flow技术测量瘤腔体积为（8.7 ± 3.8） cm3，瘤颈长（4.8 ± 1.8） mm、宽（3.0 ± 0.8） mm，血栓体积为（9.7 ± 4.2） cm3，凝血酶用量（193 ± 32） U。Fine-flow技术测量瘤腔大小与凝血酶用量及术后血栓体积相关性好于彩色多普勒超声测值。术后随访发现瘤腔封堵完全，封堵后载瘤动脉、腘动脉、足背动脉及胫后动脉的流速均无显著变化。结论 Fine-flow及彩色多普勒技术均能准确诊断PSA，Fine-flow技术在评估瘤腔体积、指导凝血酶用量方面优于彩色多普勒技术。Objective To evaluate the clinic application of Fine-flow imaging technique in ultrasound-guided percutaneous injection of thrombin for treatment of femoral artery pseudoaneurysms （PSA）. Methods A total of 29 patients with PSA were enrolled, included 21 males and 8 females, who were aged 51 - 69 years old with a mean age of 63.27. All cases were treated with thrombin injection under ultrasound-guidance. The volume of PSA, length and width of PSA neck were preoperatively measured by color Doppler and Fine-flow technique respectively. The volume of postoperative thrombus was measured, and the effect of block and complication were observed by Fine-flow imaging technique. Results The 29 PSA patients were diagnosed by gray scale ultrasound in combination with Fine-flow technique before injection, included 23 simple PSA and 6 complex PSA. Two patients with complex PSA were relapsed after first injection and cured by second injection. Measured by color Doppler, the tumor cavity volume was （6.2 ± 2.3） em3,the aneurysm neck length was （4.3 ± 1.3） mm and the width was （2.3 ± 0.9） mm. Measured by Fineflow technique, the tumor cavity volume was （8.7 ± 3.8） cm3, the anenrysm neck length was （4.8 ± 1.8） mm and the width was （3.0 ± 0.8） ram, the thrombus volume was （9.7 ± 4.2） cm3 and the amount of injected thrombin was （193 ± 32） U. Fine-flow techniques were better than color Doppler in measurement of the size of thrombus cavity, thrombin dosage and postoperative thrombosis volume. The PSA were cured successfully, the aneurysm, popliteal artery, dorsalis pedis and posterior tibial artery flow rate were not changed significantly. Conclusion It is demonstrated that Fine-flow and color Doppler technique could diagnose PSA accurately. In evaluating tumor cavity volume and amount of thrombin, the Fine-flow technique is better than color Doppler.

关 键 词：假性动脉瘤 Fine—flow超声显像 凝血酶 股动脉 

分 类 号：R445.1[医药卫生—影像医学与核医学]