AngioJet血栓抽吸联合置管溶栓与导管碎栓联合置管溶栓治疗急性肺动脉栓塞的对比研究  

AngioJet Aspiration Thrombectomy Combined with Transcatheter Thrombolysis Versus Pigtail Catheter Crushing Thrombus Combined with Transcatheter Thrombolysis in the Treatment of Acute Pulmonary Embolism:A Comparative Study

作　　者：郑光锋 李传勇 张强[1] 潘知常 史书茗 戎建杰 ZHENG Guangfeng;LI Chuanyong;ZHANG Qiang(Department of Vascular Surgery,Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou,Jiangsu Province 215009,P.R.China)

机构地区：[1]南京中医药大学附属苏州市中医医院血管外科,苏州215009

出　　处：《临床放射学杂志》2024年第11期1980-1985,共6页Journal of Clinical Radiology

基　　金：2023年度苏州市“科教兴卫”青年科技基金项目(编号:KJXW2023046);苏州市2023年度第十一批科技发展计划(基础研究-医学应用基础研究)基金项目(编号:SKY2023005)。

摘　　要：目的探讨AngioJet血栓抽吸联合置管溶栓与导管碎栓联合置管溶栓治疗急性肺动脉栓塞的临床有效性、安全性。方法回顾性分析急性肺动脉栓塞患者37例,其中采用AngioJet血栓抽吸联合置管溶栓方式治疗者12例(A组),采用导管碎栓联合置管溶栓方式治疗者25例(B组),比较两组患者导管溶栓时间、尿激酶用量、住院时间,比较两组患者治疗前后呼吸速率(RR)、心率(HR)、动脉血氧分压(PaO_(2))、动脉血氧饱和度(SaO_(2)),比较两组患者治疗有效率,并记录不良反应,术后随访比较肺动脉通畅情况。结果A组溶栓时间、尿激酶用量、住院时间均小于B组(P<0.05);对比治疗前、治疗后两组患者RR、HR水平均明显降低,PaO_(2)、SaO_(2)水平均明显升高(P<0.05);组间比较上述生命体征,术前差异无统计学意义(P>0.05),术后差异无统计学意义(P>0.05);两组总有效率差异无统计学意义(P>0.05);A组术中发生心律失常6例,术后发生血红蛋白尿5例,B组无心律失常及血红蛋白尿发生(P<0.05);A组出血相关不良反应发生率低于B组(P<0.05)。随访3~6个月,两组患者肺动脉通畅情况无差别(P>0.05)。结论AngioJet血栓抽吸联合置管溶栓及导管碎栓联合置管溶栓对急性肺动脉栓塞均具有良好的治疗效果,前者可减少溶栓时间、溶栓药物剂量及住院时间,出血并发症少,但应预防心律失常、血红蛋白尿等并发症。Objective To investigate the clinical efficacy and safety of AngioJet aspiration thrombectomy combined with transcatheter thrombolysis and pigtail catheter crushing thrombus combined with transcatheter thrombolysis in the treatment of acute pulmonary embolism.Methods A retrospective study was performed on 37 patients with acute pulmonary embolism,of which 12 cases were treated with AngioJet aspiration thrombectomy combined with transcatheter thrombolysis(group A,n=12),and 25 cases were treated with pigtail catheter crushing thrombus combined with transcatheter thrombolysis(group B,n=25).Catheter thrombolysis time,urokinase dosage and hospitalization time were compared between the two groups,and the respiratory rate(RR),heart rate(HR),arterial partial pressure of oxygen(PaO_(2)),and arterial oxygen saturation(SaO_(2))were compared between the two groups before and after treatment.The effective rate of treatment was compared between the two groups,and adverse reactions were recorded.The patency of pulmonary artery was compared during postoperative follow-up.Results The thrombolysis time,dosage of urokinase and hospitalization time in group A were lower than those in group B(P<0.05).After treatment,the RR,HR levels of patients in group A and group B were significantly decreased,while the levels of PaO_(2) and SaO_(2) were significantly increased(P<0.05).There was no significant difference in the above vital signs between the two groups before and after operation.After treatment,there was no significant difference in the total effective rate between the two groups(P>0.05).There were 6 cases of intraoperative arrhythmia and 5 cases of postoperative hemoglobinuria in group A,and no arrhythmia or hemoglobinuria in group B(P<0.05).The incidence of bleeding related adverse reactions in group A was lower than that in group B(P<0.05).After 3 to 6 months of follow-up,there was no difference in pulmonary artery patency between the two groups(P>0.05).Conclusion AngioJet aspiration thrombectomy combined with transcatheter throm

关 键 词：AngioJet血栓抽吸 置管溶栓 导管碎栓 急性肺动脉栓塞 临床观察 

分 类 号：R654.3[医药卫生—外科学]