Angiojet药物机械偶联血栓清除术治疗下肢深静脉血栓形成的探讨  

The effect of Angiojet rheolytic thrombectomy on the endovascular treatment of lower extremity deep venous thrombosis

作　　者：肖亦明[1] 莫灿均 曾汉强 张志成[1] 谭志斌[1] 范惠双[1] XIAO Yi-ming;MO Can-jun;ZENG Han-qiang;ZHANG Zhi-cheng;TAN Zhi-bin;FAN Hui-shuang(Department of interventional Radiology,Dongguan People's Hospital,Dongguan 523000,Guangdong,China)

机构地区：[1]东莞市人民医院介入科

出　　处：《广东医学》2019年第23期3279-3284,共6页Guangdong Medical Journal

基　　金：东莞市社会科技发展项目(编号:2015108101026)

摘　　要：目的探讨下腔静脉滤器植入术后Angiojet药物机械偶联血栓清除术治疗下肢深静脉血栓形成(DVT)的可行性。方法选取56例下肢DVT患者,先于健侧股静脉入路植入下腔静脉内放置滤器,后经患侧下肢深静脉入路以Angiojet血栓抽吸系统溶栓、取栓,尿激酶(UK)用量25万U^50万U,必要时行患侧髂静脉球囊扩张及支架植入。结果56例DVT患者均在下腔静脉滤器植入术后,成功进行机械偶联血栓清除术;术后疗效:痊愈38例,显效15例,有效3例,无效0例,术中及术后未出现肺动脉栓塞症状及出血现象;目前随访11~24个月,56例患侧髂静脉通畅率为100%,血栓形成后综合征发生率为8.9%。结论下腔静脉滤器置术后Angiojet药物机械偶联血栓清除术治疗下肢深静脉血栓形成安全、有效的。Objective To investigate the feasibility of Angiojet rheolytic thrombectomy for the treatment of deep venous thrombosis(DVT)of lower extremity after inferior vena cava(IVC)filter placement.Methods The clinical data of 56 patients with lower extremity DVT were collected from October 2016 to May 2018.Fifty-six patients received Angiojet rheolytic thrombectomy via the deep vein of the involved lower limb after preventive IVC filter placement.The intraoperative dose of urokinase was 250000〜500000 units.Results IVC filters and Angiojet rheolytic thrombectomy were successfully deployed in all 56 patients.The therapeutic effects were divided into four scales as follows,complete recovery(n=38),remarkable recovery(n=15),effectiveness(n=3)and ineffectiveness(n=0).No pulmonary embolism or hemorrhage occurred during the therapy.During a follow-up of 11-24 months,the incidence of iliac vein patency in 56 patients was 100%,and the incidence of post-thrombotic syndrome was 8.9%.Conclusions Angiojet rheolytic thrombectomy for the treatment of DVT of lower extremities after inferior vena cava filter placement is safe and effective.

关 键 词：静脉血栓形成 机械偶联血栓清除术 尿激酶 腔静脉滤器 

分 类 号：R364.15[医药卫生—病理学] R45[医药卫生—基础医学]