AngioJet机械吸栓治疗急性下肢深静脉血栓的临床探索  

AngioJet Percutaneous Mechanical Thrombectomy for Acute Deep Venous Thrombosis of Lower Limbs:a Clinical Exploration

作　　者：牛帅[1] 姜广伟[1] 丁殿柱[1] 吴胜春[1] NIU Shuai;JIANG Guang-wei;DING Dian-zhu;WU Sheng-chun(Department of Vascular Surgery,Hebei General Hospital,Shijiazhuang 050000,China)

机构地区：[1]河北省人民医院血管外科,河北石家庄050000

出　　处：《南昌大学学报（医学版）》2021年第2期39-43,共5页Journal of Nanchang University：Medical Sciences

基　　金：河北省医学科学研究重点计划(20190384)。

摘　　要：目的对比AngioJet机械吸栓(PMT)和导管接触性溶栓治疗(CDT)治疗急性下肢深静脉血栓(DVT)的临床疗效及安全性。方法选择54例急性DVT患者,根据随机数字表法分为对照组和研究组,各27例。对照组患者采用CDT,研究组患者采用AngioJet PMT。评价2组患者溶栓效果、住院情况及溶栓相关指标。结果研究组患者住院时间、溶栓时间和尿激酶用量均明显少于对照组[(7.52±1.23)d比(11.01±1.67)d、(2.14±0.86)d比(5.08±1.73)d、(109.34±68.62)万U比(196.54±72.01)万U,均P<0.05],但是2组静脉通畅率分级[Ⅲ级19例(70.37%)比21例(77.78%)、Ⅱ级4例(14.81%)比3例(11.11%)、Ⅰ级4例(14.81%)比3例(11.11%)]、通畅评分[(1.21±0.53)分比(1.13±0.46)分]、术中出血量[(205.34±26.03)mL比(201.16±25.81)mL]、溶栓前后患健肢周径差[(3.97±1.14)cm比(3.86±1.18)cm、(3.16±1.07)cm比(3.02±1.03)cm]及肢体消肿率[(77.34±15.17)%比(74.08±14.32)%]比较差异无统计学意义(均P>0.05)。2组患者治疗过程中均无肺梗死发生。结论AngioJet PMT的静脉通畅效果与CDT相当,但是能够有效缩短治疗时间,减少溶栓药物的用量,安全性高。Objective To compare the clinical efficacy and safety of AngioJet percutaneous mechanical thrombectomy(PMT)and catheter-directed thrombolysis(CDT)in the treatment of acute deep venous thrombosis(DVT)of the lower limbs.Methods A total of 54 patients with acute DVT were randomly assigned to receive either CDT(control group,n=27)or AngioJet PMT(study group,n=27).Thrombolytic effect,hospital stay and thrombolytic indicators were evaluated in both groups.Results Compared with control group,treatment with AngioJet PMT significantly decreased the hospitalization time((7.52±1.23)d vs(11.01±1.67)d),thrombolysis time((2.14±0.86)d vs(5.08±1.73)d),and urokinase dosage((109.34±68.62)104 U vs(196.54±72.01)104 U)(P<0.05).There were no significant differences between the two groups in the gradeⅢvenous patency rate(19(70.37%)vs 21(77.78%)),gradeⅡvenous patency rate(4(14.81%)vs 3(11.11%)),gradeⅠvenous patency rate(4(14.81%)vs 3(11.11%)),patency score(1.21±0.53 vs 1.13±0.46),intraoperative blood loss((205.34±26.03)mL vs(201.16±25.81)mL),peripheral diameter difference between the healthy and affected limbs before thrombolysis((3.97±1.14)cm vs(3.86±1.18)cm),peripheral diameter difference between the healthy and affected limbs after thrombolysis((3.16±1.07)cm vs(3.02±1.03)cm),and limb detumescence rate((77.34±15.17)%vs(74.08±14.32)%)(P>0.05).No pulmonary infarction occurred during treatment in both groups.Conclusion AngioJet PMT has the same effect as CDT for venous patency.However,AngioJet PMT can effectively and safely shorten treatment time and reduce thrombolytic agent dose.

关 键 词：AngioJet机械吸栓 导管接触性溶栓 下肢深静脉血栓 临床疗效 安全性 

分 类 号：R616[医药卫生—外科学]