超声引导下经皮瘤腔内注射凝血酶治疗医源性股动脉假性动脉瘤的疗效分析  

Clinical efficacy and safety of ultrasound-guided percutaneous thrombin injection for iatrogenic femoral pseudoaneurysm

作　　者：陈丽娅 万跃 施思 田浩 张宏伟 朱碧峰 但毕堂 左靖 CHEN Liya ,WAN Yue ,SHI Si ,TIAN Hao ,ZHANG Hong-wei ,ZHU Bifeng ,DAN Bitan ,ZUO Jing(Department off Neurology, Third Affiliated Hospital off Hubei , Diagnostic Center off Cerebralvascular Disease off Hubei , Wuhan 430033 ,Chin)

机构地区：[1]湖北省第三人民医院神经内科湖北省脑血管病诊疗中心,湖北武汉430033

出　　处：《中国实用神经疾病杂志》2018年第11期1196-1201,共6页Chinese Journal of Practical Nervous Diseases

基　　金：武汉市卫计委科研项目;编号:WX16C31

摘　　要：目的探讨超声引导下经皮凝血酶注射治疗(UGTI)医源性股动脉假性动脉瘤(FPA)的临床疗效,并评估其安全性。方法收集2009-06—2017-12湖北省第三人民医院神经内科脑血管介入术后36例发生FPA患者的临床资料,回顾性分析患者发生假性动脉瘤后压迫治疗效果、注射凝血酶治疗的效果。结果经彩色多普勒超声检查确诊的FPA患者36例,经常规压迫伴加压包扎后12例好转,24例无效;对无效的24例进行超声引导下UGTI,剂量为(28±10)IU,凝血酶溶液物质的量浓度250IU/mL,每次注射0.1~0.2mL,注射后2min内瘤腔消失,未发生远端栓塞事件。术后1周复查彩色多普勒超声无再发及并发症发生。结论对常规压迫伴加压包扎无效的FPA,在超声定位下采用远离瘤腔破口血流方向的部位进行凝血酶注射,动脉瘤填塞的成功率高,并发症发生率低。Objective To evaluate the clinical efficacy and safety of ultrasound-guided percutaneous thrombin injection（UGTI）for iatrogenic femoral pseudoaneurysm（FPA）.Methods The clinical data of 36 patients with FPA after cerebrovascular intervention from June 2009 to December 2017 in neurology department of our hospital were collected,the effect of compression therapy and thrombin injection on pseudoaneurysm were analyzed retrospectively.Results 36 FPA patients were diagnosed by color Doppler ultrasound.12 patients were improved after conventional compression and compression dressing,and were invalid in 24 patients,these patients were treated with UGTI,the dosage was（28±10）iu,thrombin solution concentration was 250 IU/mL,0.1-0.2 mL per injection.The tumor cavity disappeared within 2 min after injection,and no distal embolization occurred.No recurrence and complications were found by color Doppler ultrasonography 1 week after operation.Conclusion UGTI is effective for treatment of FPA who had no response to local compression therapy.Thrombin injection at position far away from the blood flow direction of pseudoaneurysm neck crevasse with ultrasound-guided could bring about higher success rate and less complications.

关 键 词：股动脉假性动脉瘤 凝血酶注射 超声检查 血流动力学 注射部位 脑血管介入术 脑梗死 高血压 

分 类 号：R739.4[医药卫生—肿瘤]