经血管介入治疗复杂医源性血管腔内异物的临床效果  

Clinical outcome of transvascular intervention for complex iatrogenic intravascular foreign bodies

作　　者：杜松 杨州 孙龙 张彬 李超 李中会 肖航 胡春芳 牟玮 郝迎学 DU Song;YANG Zhou;SUN Long;ZHANG Bin;LI Chao;LI Zhong-hui;XIAO Hang;HU Chun-fang;MOU Wei;HAO Ying-xue(Department of Vascular Surgery,First Affiliated Hospital of Army Medical University,Chongqing 400038,China;Department of Radiology,First Affiliated Hospital of Army Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院血管外科,重庆400038 [2]陆军军医大学第一附属医院放射科,重庆400038

出　　处：《局解手术学杂志》2023年第11期952-956,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：军队医学科技青年培育计划(20QNYP028)。

摘　　要：目的 探讨经血管介入手术在治疗复杂医源性血管腔内异物中的临床效果。方法 回顾性分析2019年3月至2022年3月在我院接受介入治疗的3例复杂医源性血管腔内异物患者的临床资料,其中导丝碎裂、刺破血管及穿透周围脏器、局部血栓机化包裹导丝并血管闭塞1例,植入性导管周围血栓形成、粘连血管及心脏瓣膜1例,导丝脱入血管并发静脉血栓形成伴血管狭窄、局部血栓机化包裹导丝1例。经静脉采用钳夹、圈套、绞缠、拖拽、套取等血管腔内介入技术治疗,观察异物取出率及手术相关并发症。结果 3例患者的异物取出率为100%,其中完全取出2例,部分取出1例(残留约5%)。出现血管损伤1例,其余2例无其他严重并发症。结论 介入术创伤小,并发症少,异物取出率高,效果显著,可作为复杂医源性血管腔内异物取出的治疗方式。Objective To investigate the clinical outcome of transvascular interventional surgery in the treatment of complex iatrogenic intravascular foreign bodies.Methods The clinical data of 3 patients with complex iatrogenic intravascular foreign bodies who received interventional treatment in our hospital from March 2019 to March 2022 were retrospectively analyzed,including 1 case of guide wire breaking,puncturing blood vessels and penetrating surrounding organs,local thrombus wrapped guide wire and blood vessel occlusion,1 case of pericatheter thrombosis,adhesion to blood vessels and heart valves,and 1 case of guide wire slipped into blood vessel lead to venous thrombosis complicated by vascular stenosis and local thrombus wrapped guide wire.The intravascular interventional techniques such as clamping,trapping,entangling,dragging and extracting through the transjugular approach were used for the treatment,and the foreign body removal rate and related complications were observed.Results The foreign body removal rate of 3 patients was 100%,of which 2 cases were completely removed and 1 case was partially removed(residual about 5%).Vascular injury occurred in 1 case,and the remaining 2 cases had no other serious complications.Conclusion Interventional surgery has the characteristics of less trauma,fewer complications,high extraction rate of foreign body,and remarkable effect,which can be used as the preferred treatment for the removal of complex iatrogenic endovascular foreign bodies.

关 键 词：介入 医源性 血管腔内异物 

分 类 号：R459.9[医药卫生—治疗学]