AngioJet血栓抽吸装置联合导管接触性溶栓治疗急性下肢动脉缺血患者的临床研究  

Clinical study of AngioJet thrombus suction device combined with catheter directed thrombolytic in the treatment of acute lower limb ischemia patients

作　　者：冯毅[1] 梁彦[1] 邓捷[1] 农昌铭 郑贵雄[1] 岑兴强[1] 曾超 钟宏[1] FENG Yi;LIANG Yan;DENG Jie;NONG Chang-ming;ZHENG Gui-xiong;CEN Xing-qiang;ZENG Chao;ZHONG Hong(Department of Cardiothoracic Vascular Surgery,Beihai People s Hospital,Beihai 536000,Guangxi,China)

机构地区：[1]北海市人民医院心胸血管外科,广西北海536000

出　　处：《川北医学院学报》2023年第6期793-796,801,共5页Journal of North Sichuan Medical College

基　　金：广西壮族自治区北海市科技计划项目(北科合201995052)。

摘　　要：目的:探讨AngioJet血栓抽吸装置联合导管接触性溶栓(CDT)对急性下肢动脉缺血(ALI)患者凝血功能、纤溶活性指标及血管内皮功能的影响。方法:根据不同治疗方式将39例ALI患者分为AngioJet血栓抽吸装置联合CDT治疗组(联合组,n=22)与CDT治疗组(CDT组,n=17)。比较两组患者手术及术后恢复相关指标、凝血功能、纤溶活性、血管内皮功能及围术期并发症发生情况。结果:联合组患者溶栓时间及住院时间、尿激酶用量均低于CDT组,住院费用高于CDT组(P<0.05)。两组患者血栓清除率及术后12个月下肢动脉通畅率比较,差异均无统计学意义(P>0.05)。治疗后,联合组患者血清APTT、TT、t-PA、eNOS水平均高于CDT组,血清Fbg、D-D、PAI-1、ET-1水平均低于CDT组(P<0.05)。两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:AngioJet血栓抽吸装置联合CDT治疗,有利于减少ALI患者尿激酶用量,缩短溶栓及住院时间,改善凝血功能与纤溶活性指标,促进血管内皮功能恢复。Objective:To investigate the effect of AngioJet thrombus suction device combined with catheter directed thrombolytic(CDT)on coagulation function,fibrinolytic activity index and vascular endothelial function in patients with acute lower limb ischemia(ALI).Methods:39 patients with ALI were selected as the study subjects.They were divided into AngioJet thrombus aspiration device combined with CDT treatment group(combined group,n=22)and CDT treatment group(CDT group,n=17)according to the treatment mode.The indexes related to operation and postoperative recovery,coagulation function,fibrinolytic activity,vascular endothelial function and perioperative complications were compared between the two groups.Results:The thrombolytic time and hospital stay in the combined group were shorter than those in the CDT group,the amount of urokinase was less than that in the CDT group,and the hospital stay cost was higher than that in the CDT group(P<0.05).There was no significant difference between the two groups in thrombus clearance rate and lower limb artery patency rate 12 months after operation(P>0.05).After treatment,the levels of serum APTT,TT,t-PA and eNOS in the combined group were higher than those in the CDT group,and the levels of serum Fbg,D-D,PAI-1 and ET-1 were lower than those in the CDT group(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:AngioJet thrombus suction device combined with CDT treatment is beneficial to reduce the amount of urokinase in patients with ALI,shorten the thrombolysis and hospitalization time,improve the coagulation function and fibrinolytic activity indicators,and promote the recovery of vascular endothelial function.

关 键 词：AngioJet血栓抽吸装置 导管接触性溶栓 急性下肢动脉缺血 凝血功能 纤溶活性 血管内皮功能 

分 类 号：R364.1[医药卫生—病理学]