AngioJet机械血栓清除治疗产褥期下肢深静脉血栓形成的临床应用  

Clinical application of AngioJet mechanical thrombectomy in the treatment of puerperal deep venous thrombosis of lower extremities

作　　者：薛明[1] 官云彪[1] 周亚东[1] 郑学洵 Xue Ming;Guan Yunbiao;Zhou Yadong;Zheng Xuexun(Department of Vascular Surgery,Fujian Medical University Union Hospital,Fuzhou 350001,Fujian,China)

机构地区：[1]福建医科大学附属协和医院血管外科,福建福州350001

出　　处：《血管与腔内血管外科杂志》2021年第8期924-928,共5页Journal of Vascular and Endovascular Surgery

基　　金：福建省微创医学中心(闽卫医政函[2017]171号)。

摘　　要：目的探讨AngioJet机械血栓清除治疗产褥期下肢深静脉血栓形成(DVT)的临床应用效果。方法收集2014年1月至2020年12月福建医科大学附属协和医院收治的40例产褥期下肢DVT患者临床资料,根据治疗方式不同分为经皮机械血栓清除(PMT)组(n=11)和导管接触性溶栓(CDT)组(n=29)。统计并比较治疗前后两组患者大腿、小腿周径差、静脉通畅情况及血红蛋白表达;比较两组患者围手术期情况(住院时间、溶栓时间、尿激酶用量);统计并发症发生情况(严重出血、致命性肺动脉栓塞、穿刺处血肿、肾功能损伤)及产后异常出血情况。结果治疗后,两组患者大腿、小腿周径差和血红蛋白水平低于治疗前;PMT组患者静脉通畅评分低于CDT组患者,静脉通畅率高于CDT组患者,差异有统计学意义(P<0.05);但两组患者大腿、小腿周径差和血红蛋白水平比较,差异无统计学意义(P>0.05)。CDT组患者住院时间和溶栓时间长于PMT组患者,尿激酶用量大于PMT组患者,差异有统计学意义(P<0.05)。CDT组患者异常出血发生率为10.3%(3/29),PMT组患者无产后异常出血情况。两组患者围手术期均未出现严重出血、致命性肺动脉栓塞和肾功能损伤等并发症;CDT组2例患者出现股静脉穿刺处血肿,PMT组患者8例出现肉眼血尿。结论AngioJet机械血栓清除在产褥期下肢DVT的治疗中可有效缩短治疗时间,减少溶栓药物用量,降低出血风险,具有更高的静脉通畅率。Objective To investigate the clinical application of AngioJet mechanical thrombectomy in the treatment of puerperal lower extremity deep venous thrombosis(DVT).Method The clinical data of 40 patients with puerperal lower extremity DVT treated in Fujian Medical University Union Hospital from January 2014 to December 2020 were collected.According to different treatment methods,they were divided into percutaneous mechanical thrombectomy(PMT)group(n=11)and catheter-directed thrombolysis(CDT)group(n=29).The peripheral diameter difference of thigh and leg,venous patency and hemoglobin expression were counted and compared between the two groups before and after treatment;the perioperative conditions of the two groups were compared(length of hospital stay,thrombolysis time and dosage of urokinase);the incidence of complications(severe bleeding,fatal pulmonary embolism,hematoma at puncture,renal function injury)and abnormal postpartum hemorrhage were counted.Result After treatment,the peripheral diameter difference of thigh and lower leg and hemoglobin level in the two groups were lower than those before treatment;the venous patency score in PMT group was lower than that in CDT group,and the venous patency rate was higher than that in CDT group(P<0.05);however,there was no significant difference in peripheral diameter difference of thigh and lower leg and hemoglobin water between the two groups(P>0.05).The length of hospital stay and thrombolysis time in CDT group were longer than those in PMT group,and the dosage of urokinase was higher than that in PMT group(P<0.05).The incidence of abnormal bleeding in CDT group was 10.3%(3/29),and there was no abnormal postpartum bleeding in PMT group.There were no complications such as severe bleeding,fatal pulmonary embolism and renal function injury in both groups;hematoma at femoral vein puncture occurred in 2 patients in CDT group and gross hematuria occurred in 8 patients in PMT group.Conclusion AngioJet mechanical thrombectomy in the treatment of puerperal DVT can effectively s

关 键 词：经皮机械血栓清除 导管接触性溶栓 产褥期 深静脉血栓形成 

分 类 号：R543[医药卫生—心血管疾病]