不同方法治疗医源性股动脉假性动脉瘤的回顾性分析并文献复习  

Retrospective analysis and literature review of different treatments for iatrogenic femoral artery pseudoaneurysm

作　　者：张楠[1] 张峰[1] 高翔[1] 邵嘉伟 毕伟[1] Zhang Nan;Zhang Feng;Gao Xiang;Shao Jiawei;Bi Wei(Department of Vascular Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北医科大学第二医院血管外科,河北石家庄050000

出　　处：《血管与腔内血管外科杂志》2022年第3期279-283,共5页Journal of Vascular and Endovascular Surgery

摘　　要：目的对不同方法治疗医源性股动脉假性动脉瘤(FAP)临床效果进行回顾性分析并文献复习。方法收集2014年4月至2020年12月河北医科大学第二医院收治47例医源性FAP患者的临床资料。统计采用不同方法治疗FAP患者的有效率。术后进行3个月至1年随访,观察不良事件。结果10例患者行超声引导下压迫治疗,7例成功,3例失败,其中2例转为外科手术,1例转为超声引导下凝血酶注射治疗。11例患者行超声下局部凝血酶注射治疗(包括1例压迫治疗失败改行凝血酶注射治疗),其中2例凝血酶注射治疗失败,改外科手术治疗,总有效率81.8%(9/11)。31例患者行外科手术治疗(包括4例改行外科手术治疗),其中股动脉FAP切除+动脉壁破口修补术18例,自体大隐静脉补片成形术11例,人工血管或自体大隐静脉转流术2例,总有效率100%(31/31)。术后随访3个月至1年,47例患者均未出现下肢功能障碍,无动脉瘤复发及下肢动脉缺血症状,疗效满意。结论超声引导下压迫、超声下局部凝血酶注射、外科手术均是治疗医源性FAP安全、有效的方法,需根据患者的具体情况进行选择。Objective To retrospectively analyze and review the literature by different treatment methods of the clinical effect in iatrogenic femoral artery pseudoaneurysm(FAP).Method The clinical data of 47 patients with iatrogenic FAP admitted to the Second Hospital of Hebei Medical University from April 2014 to December 2020 were collected.The effective rates of FAP patients treated with different methods were counted,and the adverse events were followed up from 3 months to 1 year after the operation.Result Among them,10 patients underwent ultrasound-guided compression therapy,7 patients were successful,3 patients failed,which 2 patients were converted to surgery,and 1 patient was converted to ultrasound-guided thrombin injection therapy.In addition,11 patients underwent local thrombin injection under ultrasound(including 1 patient who failed compression therapy was switched to thrombin injection),of which 2 failed thrombin injections and were switched to surgery,with a total response rate of 81.8%(9/11).The remaining 31 patients underwent surgical treatment(including 4 patients underwent surgical treatment),including 18 cases of femoral artery FAP resection+arterial wall rupture repair,11 cases of autologous saphenous vein patch plasty,artificial blood vessels,or autologous saphenous vein repair.The venous diversion was performed in 2 cases,and the total response rate was 100%(31/31).The 47 patients were followed up for 3 months to 1 year.No lower extremity dysfunction,no aneurysm recurrence,and lower extremity arterial ischemia symptoms were reported.The curative effect was satisfactory.Conclusion Ultrasound-guided compression,local thrombin injection under ultrasound,local thrombin injection under ultrasound are safe and effective methods for the treatment of iatrogenic FAP,which should be selected according to the specific situation of patients.

关 键 词：假性动脉瘤 股动脉 医源性疾病 

分 类 号：R543[医药卫生—心血管疾病]