AngioJet机械吸栓联合腔内成形术治疗下肢深静脉血栓形成的疗效评价  

Efficacy evaluation of AngioJet mechanical thrombectomy combined with angioplasty in deep venous thrombosis of lower extremity

作　　者：尹孝亮 郎德海[1] 胡明[1] 王迪[1] 胡松杰[1] 林作栋 杨磊波 Yin Xiaoliang;Lang Dehai;Hu Ming;Wang Di;Hu Songjie;Lin Zuodong(Yang Leibo.Department of Vascular Surgery,Ningbo No.2 Hospital,Ningbo 315010,China)

机构地区：[1]浙江省宁波市第二医院血管外科,315010

出　　处：《中华血管外科杂志》2018年第3期164-167,共4页Chinese Journal of Vascular Surgery

基　　金：宁波市品牌学科建设项目（PPXK2018-01）;宁波市第二医院重点学科建设项目（2016-57）;宁波市第二医院华美科研基金（2018HMKY56）

摘　　要：目的 评估应用AngioJet机械吸栓联合腔内成形术治疗急性下肢深静脉血栓形成（DVT）的临床疗效.方法 回顾性分析2015年8月至2017年9月宁波市第二医院血管外科采用AngioJet机械吸栓联合腔内成形术治疗68例下肢DVT患者的临床资料.分析AngioJet机械吸栓与腔内成形术的联合应用围术期并发症情况,并观察早中期治疗结果.结果 经AngioJet机械吸栓联合置管溶栓后,血栓Ⅲ级消除63例（92.6％）,Ⅱ级消除5例（7.4％）.患者术前术后双下肢膝上15 cm周径差[（9.0±3.4）cm比（3.6±1.5）cm]及胫骨结节下10 cm处周径差[（4.2±1.6）cm比（1.9±0.6）cm]比较,差异有统计学意义（P均〈0.05）.支架植入后髂静脉狭窄均解除.术前术后血红蛋白下降差异无统计学意义[（124±40）g/L比（112±36）g/L,P〉0.05];出现一过性肉眼血尿62例（91.2％）,经处理后血尿消失.平均住院时间为10.5 d.随访3～24个月,随访期间再发下肢肿胀、支架内血栓形成4例,经置管溶栓治疗血栓消除,管腔获得再通.结论 AngioJet机械吸栓联合腔内成形术是一种安全、有效的治疗急性下肢DVT的方法.Objective To evaluate the effect of AngioJet mechanical thrombus aspiration combined with angioplasty in acute deep venous thrombosis of lower extremity. Methods The clinical data of 68 patients with acute deep venous thrombosis of lower extremity, from August 2015 to September 2017, were retrospectively analyzed. The perioperative complications of AngioJet mechanical thrombus aspiration combined with angioplasty on acute deep venous thrombosis of lower extremity were analyzed ,and the early and mid-term outcomes were observed. Results After AngioJet mechanical thrombus aspiration combined with catheter-directed thrombolysis, 63 cases （92.6%） with grade Ⅲthrombus were eliminated, 5 cases （7.4%） with grade Ⅱ thrombus were eliminated. Comparing with pre-operation, the circumstance difference of bilateral lower extremities at 15cm above knee was （9.0±3.4）cm vs （3.6±1.5）cm, and 10cm below tibial plateau was （4.2± 1.6）cm vs. （1.9 ±0.6）cm, respectively （Both P〈0.05） . With percutaneous transluminal angioplasty and stent implantation, the iliac vein stenosis was relieved. There was no significant difference in hemoglobin decreased after the operation [（124 ±40）g/L vs. （112 ±36）g/L, P〉0.05]. The average hospitalization days were 10.5d. Temporary hematuria observed in 62 cases （91.2%）, all disappeared after symptomatic treatment. During the follow-up,4 cases recurrent lower limb swelling, stent thrombosis. The lumen was recanalization with catheter-directed thrombosis. Conclusion AngioJet mechanical thrombus aspiration combined with angioplasty is a safe and effective method for the treatment of acute deep venous thrombosis of lower extremity.

关 键 词：机械血栓抽吸术 下肢深静脉血栓形成 支架植入 

分 类 号：R65[医药卫生—外科学]