AngioJet和AcoStream血栓清除装置在亚急性期下肢深静脉血栓治疗中效果  

Efficacies of AngioJet and AcoStream on subacute lower limb deep vein thrombosis

作　　者：陈保星 李会朋[1] 郭鹏威 张华 王国华[1] CHEN Baoxing;LI Huipeng;GUO Pengwei;ZHANG Hua;WANG Guohua(Department of Vascular Surgery,Xinriang Central Hospital,Xiniang,Henan 453000,China)

机构地区：[1]新乡市中心医院血管外科,河南新乡453000

出　　处：《中华实用诊断与治疗杂志》2024年第6期584-588,共5页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20220990)。

摘　　要：目的 比较亚急性期下肢深静脉血栓(DVT)患者经皮机械血栓清除术中采用AngioJet或AcoStream血栓清除装置治疗的效果及安全性。方法 2019年12月—2023年5月新乡市中心医院诊治亚急性期下肢DVT患者87例,均行经皮机械血栓清除术,采用AngioJet血栓清除装置治疗者54例为AngioJet组,采用AcoStream血栓清除装置治疗者33例为AcoStream组。比较2组发病诱因、血栓部位、血栓范围等临床资料,记录2组血栓抽吸时间、术中失血量、尿激酶用量、髂静脉支架置入情况、导管直接性溶栓辅助治疗情况、血栓清除率、患肢消肿率、住院时间及术后血尿等并发症发生情况。术后随访6~36个月,比较2组血栓复发率、深静脉血栓后综合征发生率及Villalta评分。结果 2组发病诱因、血栓部位、血栓范围比较差异均无统计学意义(P>0.05)。AngioJet组血栓抽吸时间[(343.6±85.4)s]短于AcoStream组[(587.7±97.2)s](t=6.549,P=0.025),术中失血量[(217.9±73.1)mL]少于AcoStream组[(325.5±87.5)mL](t=7.562,P=0.019),尿激酶用量、髂静脉支架置入率、导管直接性溶栓辅助治疗率、血栓清除率、患肢消肿率、住院时间与AcoStream组比较差异均无统计学意义(P>0.05)。AngioJet组术后血尿发生率(90.7%)高于AcoStream组(3.0%)(χ^(2)=30.299,P<0.001),术后其他并发症发生率(3.7%)与AcoStream组(3.0%)比较差异无统计学意义(χ^(2)=0.192,P=0.661)。随访6~36个月,AngioJet组血栓复发率(17.6%)、深静脉血栓后综合征发生率(9.8%)、Villalta评分[(9.5±4.5)分]与AcoStream组[15.6%、9.4%、(8.5±5.5)分]比较差异均无统计学意义(P>0.05)。结论 AngioJet或AcoStream机械性血栓清除装置治疗亚急性期下肢DVT均安全、有效,其中AngioJet抽吸血栓更高效、微创,尽管术后血尿发生率较AcoStream高,但恢复较快,不影响预后。Objective To compare the efficacy and safety of AngioJet versus AcoStream thrombectomy devices in percutaneous mechanical thrombectomy for subacute lower limb deep vein thrombosis(DVT).Methods From December,2019 to May,2023,87 patients with subacute lower limb DVT underwent percutaneous mechanical thrombectomy in Xinxiang Central Hospital,among whom 54 patients used AngioJet thrombectomy device(AngioJet group)and 33 patients used AcoStream thrombectomy device(AcoStream group).The clinical data such as the etiology,thrombotic site and thrombotic range were compared between two groups.The time of thrombus aspiration,intraoperative blood loss,amount of urokinase,implantation of iliac vein stents,catheter-directed thrombolysis,thrombus clearance rate,limb swelling reduction rate,length of hospital stay,and postoperative complications as hematuria were recorded in two groups.The patients were followed up for 6 to 36 months after operation,and the recurrence rate of thrombosis,incidence of deep vein post-thrombotic syndrome,and Villalta score were compared between two groups.Results There were no significant differences in the etiology,thrombotic site and thrombotic range between two groups(P>0.05).The thrombus aspiration time was shorter in AngioJet group[(343.6±85.4)s]than that in AcoStream group[(587.7±97.2)s](t=6.549,P=0.025),the intraoperative blood loss was less in AngioJet group[(217.9±73.1)mL]than that in AcoStream group[(325.5±87.5)mL](t=7.562,P=0.019),and there were no significant differences in the amount of urokinase,iliac vein stent implantation rate,auxiliary catheter-directed thrombolysis rate,thrombus clearance rate,limb swelling reduction rate,and length of hospital stay between two groups(P>0.05).The incidence of postoperative hematuria was higher in AngioJet group(90.7%)than that in AcoStream group(3.0%)(χ^(2)=30.299,P<0.001),and there was no significant difference in the incidence of other complications between AngioJet group(3.7%)and AcoStream group(3.0%)(χ^(2)=0.192,P=0.661).During a follow-

关 键 词：下肢深静脉血栓 亚急性期 经皮机械血栓清除术 AngioJet AcoStream 

分 类 号：R654.4[医药卫生—外科学]