Angiojet血栓清除在创伤后髂股静脉近心端血栓中的应用  

Effect of AngioJet thrombectomy on proximal iliofemoral vein thrombosis after trauma

作　　者：田轩 刘建龙 贾伟 蒋鹏 程志远 张蕴鑫 李金勇 田晨阳 Tian Xuan;Liu Jianlong;Jia Wei;Jiang Peng;Cheng Zhiyuan;Zhang Yunxin;Li Jinyong;Tian Chenyang(Department of Vascular Surgery,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]积水潭医院血管外科,北京100035

出　　处：《中华普通外科杂志》2020年第9期698-702,共5页Chinese Journal of General Surgery

摘　　要：目的探讨Angiolet血栓清除装置治疗创伤后髂股静脉近心端血栓的疗效。方法选取2019年本院血管外科使用Angiojet对创伤后存在髂股静脉近心端血栓进行治疗患者的临床资料进行回顾性分析。结果使用AngioJet进行治疗的患者共76例,血栓1D级清除20例(26.3%),D级清除41例(53.9%),Ⅰ级清除15例(19.7%),使用导管吸栓或导管溶栓后血栓ID级清除34例(44.7%),Ⅱ级清除35例(46.1%),Ⅰ级清除7例(9.2%),血栓清除率明显上升(P<0.05),1例(1.3%)出现脑出血,2例(2.6%)血栓急性复发,3个月随访通畅率91.8%。结论创伤后髂股静脉近心端血栓使用AngioJet血栓清除装置是安全、有效的,术中使用尿激酶溶栓、导管吸栓和留置接触性导管溶栓治疗可增加血栓清除效果。Objective To investigate the effect of AngioJet throm bectomy on proximal iliofemoral vein thrombosis after trauma. Methods The clinical data of patients with proximal iliofemoral vein thrombosis treated with AngioJet thrombectomy were retrospectively analyzed at Vascular Surgery Department of our hospital in 2019. Results Atotal of 76 patients were enrolled. After PMT 20 patients had grade Ⅲthrombolysis clearance ( 26.3 % ) , 41 patients (53.9 % ) had grade Ⅱ clearance , and 15 cases ( 19.7 % )had grade Ⅰ clearance. Thirty four cases (44.7% ) of grade Ⅲ were cleared after catheter aspiration orcatheter thrombolysis, 35 cases (46.1%) of grade Ⅱ , 7 cases (9 .2 % ) of grade Ⅰ were cleared ,thrombus clearance rate increased significantly ( P < 0. 05 ) . Cerebral hemorrhage occurred in 1 case ( 1 .3 % ) , and throm bosis recurred in 2 cases ( 2 .6 % ) . The patency rate w as 91.8% at 3 months follow -up. Conclusions AngioJet throm bectomy is a safe and effective method for treating post-traumatic proximal iliac femoral vein thrombosis. Intraoperative application of urokinase thrombolysis, catheter aspiration and catheter-directed throm bolysis can in crease throm bus clearan ceeffect.

关 键 词：静脉血栓形成 机械溶栓 D-二聚体 纤维蛋白降解产物 

分 类 号：R654.4[医药卫生—外科学]