Aspirex机械血栓清除在急性髂股静脉血栓治疗中的应用  

Aspirex mechanical thrombectomy system in the treatment of acute iliofemoral deep vein thrombosis

作　　者：厉建林 王保恒[1] 韩达 吴世勇[1] 付一群 王彦军[1] 张勇敢[1] 杨博[1] 郭学利[1] 宋燕[1] Li Jianlin;Wang Baoheng;Han Da;Wu Shiyong;Fu Yiqun;Wang Yanjun;Zhang Yonggan;Yang Bo;Guo Xueli;Song Yan(Deparment of Vascular Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院血管外科,郑州450052

出　　处：《中华普通外科杂志》2023年第2期118-122,共5页Chinese Journal of General Surgery

摘　　要：目的评估Aspirex机械血栓清除(percutaneous mechanical thrombectomy,PMT)系统在急性髂股静脉血栓(acute iliofemoral deep vein thrombosis,IFDVT)治疗中的价值。方法回顾性分析2019年1月至2021年6月本院收治的68例IFDVT患者的临床及随访资料。结果26例患者接受PMT联合必要的导管接触溶栓(catheter directed thrombolysis,CDT)治疗,分为A组,42例接受单纯CDT治疗患者分为B组。所有患者最终血栓清除率均≥50%,均达到临床有效血栓清除。A组尿激酶(urokinase,UK)用量、溶栓时间及住院天数均低于B组,治疗24 h消肿程度优于B组,住院总费用高于B组。1年随访两组血栓后综合征(post-thrombosis syndrome,PTS)发生率、Villalta评分及一期通畅率(92.0%比90.0%,χ^(2)=0.059,P=0.807)差异均无统计学意义。结论应用Aspirex行PMT治疗急性IFDVT安全有效,可加快血栓清除,减少UK用量,缩短溶栓及住院时间,但会增加住院费用。Objective To evaluate percutaneous mechanical thrombectomy(PMT)using Aspirex device for treating acute iliofemoral deep vein thrombosis(IFDVT).Methods The clinical and follow-up data of 68 patients with IFDVT at our institution from Jan 2019 to Jun 2021 was retrospectively analyzed.Results Twenty-six patients who had received PMT combined with auxiliary catheter directed thrombolysis(CDT)were included into group A,and 42 patients received CDT alone were into group B.The final thrombus clearance rates were more than 50%,and the clinical efficacy of thrombolysis was achieved.Group A associated a significant reduction in lysis duration and UK dosage and hospital days and degree of detumescence after 24 h compared with group B,and all aforementioned differences were statistically significant.Hospitalization costs in group A were more than group B.At one year follow-up,there were no significant differences between the two groups in the cumulative prevalence post-thrombotic syndrome(PTS)and the Villalta score and primary patency(92.0%vs.90.0%,χ^(2)=0.059,P=0.807).Conclusions The application of PMT using the Aspirex device for acute IFDVT was safe and effective,which could accelerate the clearance of thrombus,and reduce UK dosage,lysis duration,hospital days.However,it increased the hospitalization costs.

关 键 词：静脉血栓形成 机械溶栓 导管接触溶栓 血栓后综合征 

分 类 号：R654.4[医药卫生—外科学]