超声引导下凝血酶注射治疗肱动脉假性动脉瘤应用价值  

Value of ultrasound-guided thrombin injection in the treatment of pseudoaneurysm of brachial artery

作　　者：于馨 张筠 张萌 里子彧 王月 金壮 YU Xin;ZHANG Yun;ZHANG Meng;LI Zi-yu;WANG Yue;JIN Zhuang(Department of Ultrasonography,General Hospital of Northern Theater Command,Shenyang 110016,China)

机构地区：[1]北部战区总医院超声诊断科,辽宁沈阳110016

出　　处：《临床军医杂志》2024年第11期1168-1170,1174,共4页Clinical Journal of Medical Officers

基　　金：2020年度沈阳市科学技术计划(20-205-4-058)。

摘　　要：目的探讨超声引导下凝血酶注射(UGTI)治疗肱动脉假性动脉瘤(PSA)的应用价值。方法选取北部战区总医院自2015年1月至2023年12月收治的23例经超声诊断为医源性PSA患者为研究对象。根据瘤腔数量将患者分成单纯型组(1个瘤腔,n=19)与复杂型组(2个及以上瘤腔,n=4)。所有患者均行UGTI治疗。记录所有患者的术后治疗效果,包括总成功率、并发症发生情况。比较单纯型组与复杂型组患者一次治疗成功率与凝血酶使用剂量。根据UGTI治疗次数将患者分为一次治疗成功组(n=21)与二次治疗成功组(n=2)。比较一次治疗成功组与二次治疗成功组患者PSA超声特征,包括瘤体体积、瘤颈直径、瘤颈速度。结果23例患者均成功完成UGTI治疗,总成功率100.0%(23/23),未发生并发症。单纯型组患者一次治疗成功率为94.7%(18/19),高于复杂型组的75.0%(3/4),但差异无统计学意义(P>0.05)。复杂型组患者平均凝血酶使用剂量为(206.3±137.5)IU,高于单纯型组的(96.7±37.7)IU,但差异无统计学意义(P>0.05)。一次治疗成功组患者瘤颈直径、瘤颈速度均小于二次治疗成功组,差异均有统计学意义(P<0.05);两组患者瘤体体积比较,差异无统计学意义(P>0.05)。结论UGTI治疗PSA安全有效,具有较高的临床应用价值;术前通过超声检查明确瘤颈直径与瘤颈速度,针对性制定合理有效的注药方法,可提高一次治疗成功率,降低复发率。Objective To investigate the application value of ultrasound-guided thrombin injection(UGTI)in the treatment of brachial artery pseudoaneurysm(PSA).Methods A total of 23 patients with iatrogenic PSA diagnosed by ultrasound were selected from General Hospital of Northern Theater Command from January 2015 to December 2023.The patients were divided into simple group(1 cavity,n=19)and complex group(2 or more cavities,n=4)according to the number of cavities.All patients were treated with UGTI.The postoperative therapeutic effects of all patients were recorded,including the total success rate and the incidence of complications.The single treatment success rate and thrombin dose were compared between simple and complex group.According to the number of UGTI treatments,the patients were divided into first successful treatment group(n=21)and second successful treatment group(n=2).The ultrasonographic characteristics of PSA,including tumor volume,tumor neck diameter and tumor neck velocity,were compared between the first and second successful treatment groups.Results All the 23 patients successfully completed UGTI treatment,the total success rate was 100.0%(23/23),and no complications occurred.The success rate of single treatment was 94.7%(18/19)in simple group,higher than 75.0%(3/4)in complex group,but the difference was not statistically significant(P>0.05).The average thrombin dose in complex group was(206.3±137.5)IU,higher than that in simple group(96.7±37.7)IU,but the difference was not statistically significant(P>0.05).The tumor neck diameter and tumor neck speed in first successful treatment group were lower than those in second successful treatment group,and the differences were statistically significant(P<0.05).There was no significant difference in tumor volume between the two groups(P>0.05).Conclusion UGTI is safe and effective in the treatment of PSA,and has high clinical application value.Preoperative ultrasonography was used to determine the diameter and velocity of the tumor neck,and reasonable and effectiv

关 键 词：超声检查 肱动脉 假性动脉瘤 超声引导下凝血酶注射 

分 类 号：R445.1[医药卫生—影像医学与核医学] R735.7[医药卫生—诊断学]