Rotarex经皮机械血栓切除术与开放取栓治疗急性下肢动脉血栓形成  

Rotarex percutaneous mechanical thrombectomy and open thrombectomy for treating acute lower extremity arterial thrombolization

作　　者：哈力木拉提·木尔提扎[1] 哈尔满·阿吉汗[1] 王护国[1] 李新喜[1] 田野[1] HALIMULATI Muertiza;HAERMAN Ajihan;WANG Huguo;LI Xinxi;TIAN Ye(Department of Vascular and Thyroid Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China)

机构地区：[1]新疆医科大学第一附属医院血管甲状腺外科,新疆乌鲁木齐830054

出　　处：《中国介入影像与治疗学》2023年第9期517-521,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的对比Rotarex经皮机械血栓切除术(PMT)与开放取栓治疗急性下肢动脉血栓形成的效果。方法回顾性分析32例接受Rotarex PMT(PMT组)及45例接受经股动脉切开取栓(开放组)治疗的急性单侧下肢动脉血栓患者,对比组间球囊使用率及支架植入率,治疗相关并发症发生率、踝肱指数(ABI)变化、疼痛缓解及血管恢复通畅情况,以及截肢率及死亡率。结果对全部患者均成功完成治疗。PMT组球囊使用率及支架植入率均高于开放组(P均<0.05)。组间治疗相关并发症发生率差异无统计学意义[3.13%(1/32)vs.13.33%(6/45),χ^(2)=2.358,P=0.229]。治疗前组间ABI差异无统计学意义(P>0.05),治疗后3天PMT组ABI低于开放组[(0.77±0.01)vs.(0.84±0.17),P=0.013],治疗后1个月PMT组ABI高于开放组[(0.80±0.15)vs.(0.72±0.12),P=0.010]。治疗后1个月,PMT组疼痛改善率为90.63%(29/32),高于开放组[77.78%(35/45),P=0.033]。治疗后1、3、6及12个月,组间血管通畅率差异均无统计学意义(P均>0.05)。治疗后12个月,PMT组截肢率及死亡率[9.38%(3/32)、3.13%(1/32)]与开放组[8.89%(4/45)、4.44%(2/45)]差异均无统计学意义(P均>0.05)。结论Rotarex PMT治疗急性下肢动脉血栓与开放取栓效果相当,且更利于缓解症状。Objective To compare the effect of Rotarex percutaneous mechanical thrombectomy(PMT)and open thrombectomy for treating acute lower extremities arterial thrombolization.Methods Data of 77 patients with acute lower extremity arterial thrombolization who underwent Rotarex PMT(PMT group,n=32)or femoral artery incision and open thrombectomy(open group,n=45)were retrospectively analyzed.Balloon usage rate and stent implantation rate during treatment,the incidence of therapeutic-related complications,changes of ankle-brachial index(ABI),pain relief and vascular patency,and the amputation rate and mortality rate after treatments were compared between groups.Results All patients successfully completed thrombectomy.During treatment,balloon usage rate and stent implantation rate in PMT group were higher than those in open group(both P<0.05).No significant difference of therapeutic-related complications was found between groups(3.13%[1/32]vs.13.33%[6/45],χ^(2)=2.358,P=0.229).ABI was not significantly different between groups before treatment(P>0.05),while in PMT group was lower than in open group 3 days after treatment([0.77±0.01]vs.[0.84±0.17],P=0.013),but in PMT group was higher than in open group 1 month after treatment([0.80±0.15]vs.[0.72±0.12],P=0.010).One month after treatment,the pain improvement rate in PMT group was 90.63%(29/32),higher than that in open group(77.78%[35/45],P=0.033).One,3,6 and 12 months after treatment,no significant difference of vascular patency rate was found between groups(all P>0.05).Twelve months after treatment,no significant difference of amputation nor mortality rate was found between PTM group(9.38%[3/32],3.13%[1/32])and open group(8.89%[4/45],4.44%[2/45],both P>0.05).Conclusion The effect of Rotarex PMT for treating acute arterial thrombolization of lower extremity was comparable to that of open thrombectomy,while the former was more conducive to relieving symptoms.

关 键 词：血栓形成 下肢 血栓切除术 

分 类 号：R543[医药卫生—心血管疾病] R815[医药卫生—内科学]