AngioJet血栓抽吸治疗急重症肺血栓栓塞症的疗效分析  

Clinical analysis of AngioJet percutaneous mechanical thrombectomy system in treatment of acute and severe pulmonary thromboembolism

作　　者：张建陶 高红霞 田宇 刘佳豪 焦乐 续慧民 郝斌 杨涛 Zhang Jiantao;Gao Hongxia;Tian Yu;Liu Jiahao;Jiao Le;Xu Huimin;Hao Bin;Yang Tao(Department of Vascular Surgery,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Third Hospital of Shanxi Medical University,Taiyuan 030032,China)

机构地区：[1]山西白求恩医院山西医学科学院同济山西医院山西医科大学第三医院血管外科,山西太原030032

出　　处：《中国血管外科杂志（电子版）》2024年第1期68-72,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：山西省重点研发计划项目(201903D321154)。

摘　　要：目的评价AngioJet血栓抽吸治疗急性重症肺栓塞的疗效和安全性。方法前瞻性收集2019年1月至2021年6月在山西白求恩医院诊断为急性重症肺栓塞的60例患者,随机分为血栓抽吸组及导管溶栓组各30例,其中血栓抽吸组采用AngioJet血栓抽吸+抗凝治疗,导管溶栓组行导管溶栓+抗凝治疗,比较两组术后情况以及随访1年内的氧分压及肺动脉压。结果手术均取得成功。血栓抽吸组患者术后的肺动脉压、动脉血氧分压及血氧饱和度和术前相比差异有统计学意义(P<0.05),其中肺动脉压和导管溶栓组相比差异有统计学意义(P<0.05),而动脉血氧分压及血氧饱和度差异有统计学意义(P>0.05)。两组患者在术后1、3、6、12个月的肺动脉压及动脉血氧分压的差异均无统计学意义(P>0.05)。血栓抽吸组5例患者出现血尿,对症处理后消失。患者均未出现肾功能不全、高钾血症及严重出血等并发症,随访期间无血栓复发或死亡病例。结论AngioJet血栓抽吸安全有效,能明显改善患者的肺动脉压、血氧分压及血氧饱和度,但远期疗效与导管溶栓相比相差不大。Objective To evaluate the efficacy and safety of AngioJet percutaneous mechanical thrombectomy system in treatment of acute and severe pulmonary thromboembolism.Methods The clinical data of 60 patients diagnosed with acute severe pulmonary embolism at Shanxi Bethune Hospital from January 2019 to June 2021 were prospectively collected and randomly divided into thrombus aspiration group and catheter thrombolysis group of 30 patients each.The thrombus aspiration group used AngioJet thrombus aspiration combined with anticoagulation therapy,and the catheter thrombolysis group simply received catheter thrombolysis and anticoagulation therapy.The postoperative conditions and the partial pressure of oxygen and pulmonary artery pressure within 1 year of follow-up were compared between the two groups.Results All surgeries were successful.The postoperative pulmonary artery pressure,arterial partial pressure of oxygen and oxygen saturation of patients in the thrombus aspiration group were significantly different from those before surgery(P<0.05).Among them,the pulmonary artery pressure was significantly different from that of the catheter thrombolysis group(P<0.05),while the difference in arterial blood oxygen partial pressure and oxygen saturation were not statistically significant(P>0.05).There were no statistically significant differences in pulmonary artery pressure and arterial oxygen partial pressure between the two groups at 1,3,6,and 12 months after surgery(P>0.05).Five patients in the thrombus aspiration group developed hematuria,which disappeared after symptomatic treatment.None of the patients developed complications such as renal insufficiency,hyperkalemia or severe bleeding,and there were no cases of recurrence of thrombosis or death during the follow-up period.Conclusion AngioJet percutaneous mechanical thrombectomy system is safe and effective,which can significantly improve patients’pulmonary artery pressure,partial pressure of blood oxygen and oxygen saturation.However,the long-term efficacy is not much di

关 键 词：肺栓塞 导管接触溶栓 经皮机械性血栓清除 

分 类 号：R563.5[医药卫生—呼吸系统]