术前血栓预处理在AngioJet治疗下肢深静脉血栓形成中的作用  

Thrombo-pretreatment in AngioJet mechanical thrombectomy

作　　者：张章 郭松林 阴继凯 王栋 王磊 Zhang Zhang;Guo Songlin;Yin Jikai;Wang Dong;Wang Lei(Department of General Surgery,Tangdu Hospital,Fourth Military Medical University,Xi'an 710038,China)

机构地区：[1]空军军医大学唐都医院普通外科,西安710038

出　　处：《中华普通外科杂志》2020年第5期384-388,共5页Chinese Journal of General Surgery

基　　金：陕西省重点研发计划项目(2017ZDXM-SF-038)。

摘　　要：目的探讨术前血栓预处理在AngioJet血栓清除术中的作用.方法按纳入标准选取急性期单侧髂股静脉血栓患者共68例,随机分为实验组和对照组,对比观察术前经腘静脉置鞘小剂量溶栓药物预处理是否可进一步提高AngioJet血栓清除效率.结果经预处理后,实验组术中即时血栓清除率较对照组高(Z-2.446,P=0.014),血栓抽吸时间更短[(289.1±57.9)s比(342.3±75.2)s],术后第1天血红蛋白降低更少[(7.2±2.4)g/L比(11.4±2.1)g/L];术后随访3、12及24个月深静脉通畅率无差异,远期深静脉血栓后综合征(PTS)发生率无差异.结论经腘静脉置鞘小剂量溶栓药物预处理,可提高术中即时血栓清除效率,有效减少血栓抽吸时间及红细胞破坏.Objective To evaluate thrombo-pretreatment in AngioJet mechanical thrombectomy.Methods 68 acute DVT patients were randomized into two groups:thrombo-pretreatment with low-dose urokinase via popliteal vein before operation(experimental group)comparing with those undergoing upfront surgery.Results Afer pretreatment,the immediate thrombus clearance grade in the experimental group was higher than that in the control group(Z=2.446,P=0.014),the procedure time was shorter[(289.1±57.9)s rs.(342.3±75.2)s]and less hemoglobin decreased after operation[(7.2±2.4)g/Lus.(11.4±2.1)g/L].There was no dfference in the deep vein patency and the ineidence of PTS between the two groups at 3,12 and 24 months after operation.Conclusion Pre-treatment with low dose urokinase before operation can improve the efficiency of PMT,ffectively reduce the time of AngioJet activation and the destruetion of red blood cells.

关 键 词：静脉血栓形成 机械溶栓 

分 类 号：R654.4[医药卫生—外科学]