超声引导下股动脉假性动脉瘤血管腔内缝合术的临床价值探讨  

Clinical Application of Ultrasound-Guided Endovascular Suture in Femoral Artery Pseudoaneurysm

作　　者：张国辉 晋艳玲 程艳 袁盛兴 刘淼 朱恩全 陈坤前 Zhang Guohui;Jin Yanling;Cheng Yan;Yuan Shengxing;Liu Miao;Zhu Enquan;Chen Kunqian(Department of Ultrasound,The NO.1 Hospital of Qujing,Qujing,Yunnan 655000,China;Department of Cardiovascular Surgery,The NO.1 Hospital of Qujing,Qujing,Yunnan 655000,China)

机构地区：[1]曲靖市第一人民医院超声科,655000 [2]曲靖市第一人民医院心脏血管外科,云南省曲靖市655000

出　　处：《中国超声医学杂志》2024年第10期1139-1142,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨股动脉介入手术穿刺后假性动脉瘤在超声实时引导下行血管腔内缝合术的临床应用价值。方法选取因各种介入手术穿刺股动脉后导致假性动脉瘤,且在我院超声科与血管外科合作下经超声引导行血管腔内缝合术的32例患者,分析股动脉假性动脉瘤的特征及超声引导下血管腔内缝合假性动脉瘤的安全性及有效性。结果32例患者瘤体最大直径27~76 mm,平均最大直径(43.88±11.6)mm、瘤颈长度1.8~9.7 mm,平均长度(3.33±1.43)mm、瘤口大小1.5~3.6 mm,平均大小(2.23±0.54)mm,瘤口最大流速105~625 cm/s,平均最大流速(296.12±99.09)cm/s,28例患者成功经超声引导下血管腔内缝合股动脉破口,2例瘤口残余微小分流联合凝血酶冻干粉治疗后闭合,2例患者腔内缝合治疗失败后改行外科手术修复股动脉,所有患者术后24 h、1个月、6个月随访期内无感染、复发、破裂出血等并发症。结论随着介入微创手术的广泛开展,股动脉穿刺后假性动脉瘤的发生率显著上升,超声作为假性动脉瘤确诊的首选影像学方法,同时在超声引导下穿刺假性动脉瘤行腔内缝合术微创、安全、有效,可明显缩短手术时间,降低并发症发生率。对于瘤体大、流速快、瘤颈宽的股动脉假性动脉瘤可作为首选治疗方式。Objective To explore the clinical application value of ultrasound-guided endovascular suture for femoral artery pseudoaneurysm.Methods 32 patients diagnosed with pseudoaneurysms,which were caused by puncture of the femoral artery due to interventional surgery,were enrolled.All the patients underwent endovascular suture under ultrasound guidance.To analyze the feasibility,safety and effectiveness of ultrasound-guided endovascular suture for femoral artery pseudoaneurysms(FAP).Results Among the 32 patients,the maximum tumor diameter was 27~76(43.88±11.6)mm,the tumor neck length 1.8~9.7(3.33±1.43)mm,the tumor neck diameter 1.5~3.6(2.23±0.54)mm,and the maximum flow velocity in the tumor neck was 105~625(296.12±99.09)cm/s.28 patients received successful treatment with suture under ultrasound guidance.Two cases experienced residual small shunt,and coagulation freeze-dried powder treatment was administered.Two patients were converted to surgical repair due to failure of endovascular suture.All patients were followed up for 24 hours,at 1 month and 6 months after operation,and no recurrence,FAP rupture or femoral artery stenosis was reported.Conclusions Endovascular suture under ultrasound guidance is feasible,safe and effective for treatment of FAP.For FAP with large tumors,fast flow velocity,short and wide necks,ultrasound-guided endovascular suture can be used as the first choice for treatment.

关 键 词：超声引导 股动脉 假性动脉瘤 血管缝合器 

分 类 号：R445.1[医药卫生—影像医学与核医学] R654.4[医药卫生—诊断学]