大腔导管手动抽吸治疗急性中央型下肢深静脉血栓的有效性及安全性  

Efficacy and safety of manual aspiration thrombectomy using large- size catheter for the treatment of acute central deep venous thrombosis

作　　者：韩伟[1] 王林君[1] 王松茂[1] 董阳民 孟路阳[1] 田坤[1] 蒋焕乐 HAN Wei;WANG Linjun;WANG Songmao(Department of Vascular Surgery,Hangzhou Third Municipal Hospital,Hangzhou 310009,China)

机构地区：[1]杭州市第三人民医院血管外科

出　　处：《浙江医学》2019年第23期2529-2532,2539,共5页Zhejiang Medical Journal

摘　　要：目的探讨大腔导管手动抽吸(MAT)技术治疗急性中央型下肢深静脉血栓(DVT)的有效性及安全性。方法回顾性分析接受血栓清除治疗的41例急性中央型DVT患者的临床资料,其中采取MAT辅助导管接触性溶栓(CDT)治疗(A组)15例,经皮机械性血栓清除术(PMT)辅助CDT治疗(B组)26例。观察并比较两组患者手术时间、放射暴露时间、血栓清除率、植入支架比例、治疗持续时间、尿激酶(UK)总用量、手术前后Hb变化、住院时间、总费用、介入耗材费用、6个月时Villalta评分、不良事件发生情况等指标。结果两组技术成功率均为100.0%。A组患者治疗持续时间、UK总用量均高于B组,介入耗材费用低于B组,差异均有统计学意义(均P<0.05);两组患者手术时间、放射暴露时间、血栓清除率、植入支架比例、住院时间、总费用、6个月时Villalta评分等指标比较,差异均无统计学意义(均P>0.05)。两组患者均无穿刺点、消化道及颅内等严重出血事件发生;术中及术毕前造影均未发现血管壁损伤;无症状性肺动脉栓塞(PE)等不良事件。结论MAT技术治疗中央型DVT有效、经济、安全,可在临床推广应用。Objective To evaluate the efficacy and safety of manual aspiration thrombectomy(MAT)using large-size catheter in treatment of acute central deep venous thrombosis(DVT).Methods Clinical data of 41 patients who underwent thrombectomy for the treatment of acute central DVT were retrospectively analyzed.Among 41 patients,15 cases(group A)received large-size catheter MAT with adjunctive catheter-directed thrombolysis(CDT),and 26 cases(group B)underwent percutaneous mechanical thrombectomy(PMT)with adjunctive CDT.Demographic information,onset to operation time,procedure duration,X-ray exposure time,total dosage of urokinase,length of hospital stay,total costs,costs of procedure materials,thrombus clearance rate,hemoglobin(Hb)decreases,peri-and post-procedure adverse events were compared between the two groups.Results The procedure success rate was 100%in both groups.Length of the whole intervention period and total dosage of urokinase in group A were significantly increased compared with group B,while costs of procedure materials in group A were significantly lower than those of group B(P<0.05).There were no statistically significant differences for other variables between the two groups(P>0.05).No adverse events including puncture site hemorrhage and massive alimentary tract or intracranial bleeding,symptomatic pulmonary artery embolism(PE),and vessel wall damage occurred during and after the procedure in both groups.Conclusion MAT using large-size catheter is effective,cost-effective and safe for thrombus removal in treatment of acute central deep venous thrombosis.

关 键 词：深静脉血栓 大腔导管手动抽吸 导管接触性溶栓 经皮机械性血栓清除术 

分 类 号：R47[医药卫生—护理学]