AngioJet Ultra机械血栓清除系统在早期急性肠系膜上动脉缺血性疾病中应用效果的多中心研究  

A Multicenter Study on the Efficacy of AngioJet Ultra Mechanical Thrombus Clearance System in Early Acute Superior Mesenteric Artery Ischemic Disease

作　　者：王国华[1] 张华 陈保星 李会朋[1] 化召辉[2] 崔文军[3] 陆信武[4] WANG Guohua;ZHANG Hua;CHEN Baoxing;LI Huipeng;HUA Zhaohui;CUI Wenjun;LU Xinwu(Department of Vascular Surgery,Xinxiang Central Hospital,Xinxiang 453000,China;Department of Vascular Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Vascular Surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450070,China;Department of Vascular Surgery,Ninth People’s Hospital Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]新乡市中心医院血管外科,河南新乡453000 [2]郑州大学第一附属医院血管外科,河南郑州450052 [3]郑州大学第五附属医院血管外科,河南郑州450070 [4]上海交通大学医学院附属上海第九人民医院血管外科,上海200011

出　　处：《河南医学研究》2024年第17期3073-3076,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划项目(LHGJ20220990)。

摘　　要：目的探讨AngioJet Ultra机械性血栓清除系统治疗早期急性肠系膜上动脉缺血(AMI)的临床效果。方法回顾性分析4家医院2017年3月至2022年9月收治的49例AMI患者资料。患者入院后明确诊断,急诊行AngioJet Ultra系统实施肠系膜上动脉血栓清除,术后观察其临床疗效、安全性及6、12、24、36、48个月随访情况。结果所有患者均顺利完成血栓清除术治疗,技术成功率100.0%,残余狭窄11例,给予球囊扩张成形术,支架置入8例,其中2例肠系膜上动脉夹层,遂置入2枚支架,余36例术后复查造影示肠系膜上动脉血栓清除满意。46例术后腹痛均缓解,2例腹痛加重,并行急诊行剖腹探查术,术后恢复可,1例术后死于多器官功能衰竭,术后9例出现血红蛋白尿,24 h后均恢复正常。术后6~48个月随访,1例失访,2例死亡,1例术后16个月停用华法林钠片复发,1例术后36个月出现肠系膜上动脉重度狭窄,行药物球囊扩张成形术。结论AngioJet Ultra机械性血栓清除系统治疗AMI方法临床效果满意,微创、安全性良好,可作为早期AMI的腔内介入治疗首选方案。Objective To explore the clinical efficacy of AngioJet Ultra mechanical thrombus clearance system in the treatment of acute mesenteric ischemia(AMI).Methods Retrospective analysis of 49 patients with AMI admitted in 4 hospitals from March 2017 to September 2022.Patients were definite diagnosis after admission,emergency AngioJet Ultra system for superior mesenteric artery thrombosis removal,the clinical efficacy and safety were observed after operation,and follow up at 6,12,24,36 and 48 months after operation.Results All patients successfully completed thrombectomy,with a technical success rate of 100.0%,11 patients had residual stenosis,balloon dilatation and angioplasty were performed.Stents were placed in 8 patients,including 2 patients with superior mesenteric artery dissection,2 stents were then placed,the remaining 36 patients showed satisfactory removal of superior mesenteric artery thrombus by reexamination after operation.Postoperative abdominal pain was relieved in 46 cases,and worsened in 2 cases.The emergency laparotomy was performed in parallel,and the postoperative recovery was good,1 case died of multiple organ failure after operation,9 cases developed red blood and white urine after operation,and returned to normal 24 hours later.During 6-48 months follow-up,1 case lost follow-up,2 cases died,1 case stopped warfarin sodium tablets and relapsed again 16 months after operation,and 1 case developed severe stenosis of superior mesenteric artery 36 months after operation,and underwent drug balloon dilatation.Conclusion AngioJet Ultra mechanical thrombus clearance system has satisfactory clinical efficacy,minimally invasive and good safety in the treatment of AMI,and can be used as the first choice for endovascular interventional treatment of early AMI.

关 键 词：急性肠系膜上动脉缺血 机械性血栓清除系统 随访 

分 类 号：R654.4[医药卫生—外科学]