AngioJet血栓抽吸联合内膜剥脱术治疗急性下肢动脉缺血病变的疗效分析  

Effect analysis of AngioJet thrombus aspiration combined with endarterectomy in the treatment of acute lower extremity arterial ischemia

作　　者：农昌铭 冯毅[1] 朱庆华 伍际琪[1] 钟宏[1] NONG Changming;FENG Yi;ZHU Qinghua;WU Jiqi;ZHONG Hong(Cardiovascular Thoracic Surgery,Beihai People’s Hospital,Beihai,536000,Guangxi,China)

机构地区：[1]北海市人民医院胸心血管外科,广西北海536000

出　　处：《大医生》2023年第13期1-4,共4页Doctor

基　　金：北海市科技术计划项目(编号:北科合201995052)。

摘　　要：目的 探讨AngioJet血栓抽吸联合内膜剥脱术用于急性下肢动脉缺血病变治疗中的效果,为临床提供参考。方法 回顾性分析2018年6月至2020年12月北海市人民医院收治的60例急性下肢动脉缺血患者的临床资料。根据治疗方案不同分为基础组(30例,行Fogarty导管取栓联合内膜剥脱术治疗)与试验组(30例,行AngioJet血栓抽吸联合内膜剥脱术治疗)。比较两组患者围术期指标、凝血功能、血栓清除情况、下肢动脉通畅情况、下肢血管病变情况及并发症发生情况。结果 试验组患者手术时间长于基础组,住院时间短于基础组(P<0.05)。术后,两组患者血清纤维蛋白原(FIB)、D-二聚体(D-D)水平低于术前,凝血酶原时间(PT)长于术前,且试验组患者血清FIB、D-D水平低于基础组,PT长于基础组(P<0.05)。试验组患者血栓清除情况优于基础组,下肢动脉通畅率高于基础组(P<0.05)。术后,两组患者足背动脉峰值流速、足背动脉血流量及踝肱指数(ABI)高于术前,且试验组高于基础组(P<0.05)。试验组患者并发症发生率低于基础组(P<0.05)。结论 AngioJet血栓抽吸联合内膜剥脱术治疗急性下肢动脉缺血病变安全有效,可有效清除血栓,恢复下肢血流,缓解临床症状,且通畅率较高。Objective To investigate the clinical effect of AngioJet thrombus aspiration combined with endarterectomy in the treatment of acute lower extremity arterial ischemia.Methods Clinical data about 60 acute lower extremity arterial ischemia patients admitted to the Beihai People’s Hospital from June 2018 to December 2021 were retrospectively analyzed.According to different treatment plans,they were divided into the basic group(30 cases,Fogarty catheter thrombectomy combined with endomycotomy)and the experimental group(30 cases,AngioJet thrombus aspiration combined with endomycotomy).Perioperative indexes,coagulation function,thrombus clearance,lower limb artery patency,lower limb vascular lesions and complications were compared between the two groups.Results The operation duration of the experimental group was longer than that in the basic group,and the hospitalization time was shorter than that in the basic group(P<0.05).After surgery,serum fibrinogen(FIB)and D-dimer(D-D)levels in two groups were lower than those before surgery,and prothrombin time(PT)was longer than those before surgery,and serum FIB and D-D levels in experimental group were lower than that in basic group,and PT was longer than that in basic group(P<0.05).The surgical success rate,thrombus clearance rate and lower limb artery patency rate of the experimental group were higher than those of the basic group(P<0.05).After surgery,the peak velocity of dorsal pedis artery,dorsal foot artery blood flow and ankle brachial index(ABI)in two groups were higher than those before surgery,and the experimental group was higher than that in the basic group(P<0.05).The complication rate of the experimental group was lower than that of the basic group(P<0.05).Conclusion AngioJet thrombus aspiration combined with endarterectomy is safe and effective in the treatment of acute lower extremity arterial ischemia,which can effectively remove thrombus,restore lower limb blood flow,relieve clinical symptoms and has a high patency rate.

关 键 词：AngioJet血栓抽吸 内膜剥脱术 急性下肢动脉缺血 

分 类 号：R654.3[医药卫生—外科学]