血栓真空抽吸导管与导管接触性溶栓治疗急性下肢动脉缺血的对比研究  

Comparative study of thrombus vacuum aspiration catheter versus catheter-directed thrombolysis for the treatment of acute lower limb ischemia

作　　者：赵敬熊 李晓强 李文东 王炜[1] 孙莉莉 陈弘 Zhao Jingxiong;Li Xiaoqiang;Li Wendong;Wang Wei;Sun Lili;Chen Hong(Department of Vascular Surgery,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu,China)

机构地区：[1]南京大学医学院附属鼓楼医院血管外科,江苏南京210008

出　　处：《中国血管外科杂志(电子版)》2024年第4期346-350,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：江苏省学生体质健康促进研究中心重点课题(2023A002)。

摘　　要：目的比较血栓真空抽吸导管(thrombus vacuum aspiration catheter,TVAC)与导管接触性溶栓(catheter directed thrombolysis,CDT)治疗急性下肢动脉缺血(acute lower limb ischemia,ALLI)患者的短期疗效。方法回顾性分析2023年3~8月于南京大学医学院附属鼓楼医院就诊的38例ALLI患者临床资料,根据手术方式分为TVAC组(20例)与CDT组(18例)。术后患者随访6个月,以心肌梗死溶栓(thrombolysis in myocardial infarction,TIMI)血流分级评估肢体血供变化,以Cooley疗效评分评估治疗效果。结果患者手术均取得成功,TVAC临床技术成功率为95.0%(19/20),CDT为88.9%(16/18)。TVAC组患者住院时间较CDT组缩短,差异有统计学意义[(7.65±1.93)d比(11.72±3.78)d,P<0.001]。术后6个月随访,TVAC组有1例患者死于心肌梗死,其余患者无下肢缺血性溃疡、坏死、截肢事件,两组患者TIMI分级及Cooley疗效评分差异均无统计学意义(P>0.05)。结论TVAC治疗ALLI的短期疗效不劣于CDT,可有效缓解症状。Objective To compare the short-term efficacy of thrombus vacuum aspiration catheter(TVAC)versus catheter directed thrombolysis(CDT)in the treatment of patients with acute lower limb ischemia(ALLI).Methods The clinical data of 38 patients with ALLI who were treated at Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School from March to August 2023 were analyzed retrospectively.Patients were divided into TVAC group(20 cases)and CDT group(18 cases)according to the surgical methods.The patients were followed up for 6 months after surgery,and the changes in limb blood supply were evaluated by thrombolysis in myocardial infarction(TIMI)blood flow classification,and the treatment effect was evaluated by Cooley efficacy score.Results All patients’operations were successful.The clinical success rate of TVAC and CDT were 95.0%(19/20)and 88.9%(16/18),retrospectively.The hospital stay of patients in the TVAC group was shorter than that in the CDT group,with statistically significant difference(7.65±1.93 d vs 11.72±3.78 d,P<0.001).After 6 months of follow-up,one patient in the TVAC group died of myocardial infarction,and the remaining patients had no lower limb ischemic ulcers,necrosis or amputation.There were no statistically significant differences in TIMI classification and Cooley efficacy score between the two groups(P>0.05).Conclusion The short-term efficacy of TVAC in treating ALLI is not inferior to CDT and can effectively relieve symptoms.

关 键 词：急性下肢动脉缺血 接触性导管溶栓 血栓真空抽吸导管 

分 类 号：R54[医药卫生—心血管疾病]