超声造影在经皮注射凝血酶原治疗肢体假性动脉瘤中的应用  

The use of contrast-enhanced ultrasound in the treatment of limb pseudoaneurysm with percutaneous prothrombin injection

作　　者：陈重[1] 李茜[1] 陶杰[1] 赖小今[1] 邓旦[1] 廖明松[1] 吴晓波[1] 赵恒[1] 

机构地区：[1]成都军区总医院超声科,成都610083

出　　处：《解放军医学杂志》2014年第1期40-43,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨超声造影引导下经皮凝血酶原注射治疗肢体假性动脉瘤(PSA)的安全性及有效性。方法 16例下肢动脉PSA患者行超声造影引导下经皮穿刺凝血酶原注射治疗,记录瘤腔大小、瘤颈宽度及长度、压迫次数、压迫时间及凝血酶原注射剂量。结果 16例PSA患者共20个瘤囊,其中13例为1个瘤囊,2例为2个瘤囊,1例为3个瘤囊。瘤腔最大径线值为41.1±11.9mm,瘤颈宽度1.9±0.5mm,瘤颈长度4.4±2.3mm,治疗压迫时间6.0±2.0min,压迫次数为1.2±0.4次,凝血酶原注射量411.5±118.8U。一次注射治疗成功率100%(16/16),无复发,无并发症发生。结论超声造影引导下经皮凝血酶原注射治疗远端肢体PSA安全有效,瘤腔大小及瘤颈长度为影响治疗的重要因素,再次及时压迫是提高治愈率的重要步骤。Objective To explore the safety and effectiveness of contrast-enhanced ultrasound （CEUS）-guided percutaneous injection ofprothrombin for the treatment of limb pseudoaneurysm （PSA）. Methods Sixteen cases of lower limb pseudoaneurysms were treated with contrast-enhanced ultrasound （CEUS）-guided percutaneous injection of prothrombin, and the size of the pseudoaneurysm, width and length of the pseudoaneurysm neck, times for compression, duration of each compression, and dose of prothrombin injection were recorded. Results In 16 pseudoaneurysm patients, there were 20 pseudoaneurysm sacs in total. One pseudoaneurysm sac was present in 13 patients, 2 sacs were present in 2, and there were 3 sacs in one patient. The mean maximum diameter of the sacs was 41.1 ± 11.9mm. The mean width and length of these pseudoaneurysm necks were 1.9 ± 0.Smm and 4.4 ± 2.3mm respectively. During the process of treatment, the mean duration for compression was 6.0 _± 2.0min, and the mean number of times of compression was 1.2 ± 0.4. The mean dose of prothrombin injection was 411.5 ± 118.8U. The cure rate with one-injection was 100% （16/16）, and the recurrence rate was 0%. No complications was observed. Conclusions CEUS-guided percutaneous injection of prothrombin for the treatment of lower limb pseudoaneurysms is safe and effective. The size of the pseudoaneurysm sac and length of the pseudoaneurysm neck are important factors that may affect the result of the treatment. Timely recompression is an important step for increasing the cure rate.

关 键 词：造影剂 凝血酶原 动脉瘤 假性 超声检查 

分 类 号：R543.16[医药卫生—心血管疾病] R319.2[医药卫生—内科学]