AngioJet机械血栓抽吸术对下肢动脉硬化闭塞症合并急性血栓形成的临床疗效评估  

Clinical evaluation of AngioJet mechanical thrombus aspiration for the treat⁃ment of arteriosclerosis obliterans complicated with acute thrombosis

作　　者：宁玮 朱乾坤 王东旭 逄锦鹏 李任飞[1] 邹常咏[1] 闫 NING Wei;ZHU Qian⁃kun;WANG Dong⁃xu;PANG Jin⁃peng;LI Ren⁃fei;ZOU Chang⁃yong;YAN Yan(Department of Interventional Vascular Surgery,The Fourth Affiliated Hospital of Harbin Medi⁃cal University,Harbin 150001,China)

机构地区：[1]哈尔滨医科大学附属第四医院介入血管外科,黑龙江哈尔滨150001

出　　处：《哈尔滨医科大学学报》2024年第5期482-487,共6页Journal of Harbin Medical University

基　　金：2022年度黑龙江省省属高等学校基本科研业务费科研项目(2022-KYYWF-0293);哈尔滨医科大学附属四院创新人才(HYDSYCXRC202117);黑龙江省博士后资助课题(LBH-Z18229)

摘　　要：目的 通过回顾性研究探讨AngioJet机械血栓抽吸术与下肢动脉切开取栓手术的临床治疗效果。方法 收集2020年1月~2022年2月哈尔滨医科大学附属第四医院介入血管外科病房收治的42例下肢动脉硬化闭塞症合并急性血栓形成(arteriosclerosis obliterans complicated with acute thrombosis, ASOCAT)患者的临床资料,分为AngioJet机械血栓抽吸术组和下肢动脉切开取栓术组,分别入选26例和16例。AngioJet机械血栓抽吸术组采用AngioJet血栓抽吸导管抽吸下肢动脉血栓;下肢动脉切开取栓术组通过切开股动脉后使用Fogarty球囊取栓导管取出下肢动脉血栓。所有入组的患者术前完善相关常规检查,包括血细胞分析、生化全项、凝血常规、尿液综合分析、心电向量图、心脏彩超、下肢血管彩超或下肢动脉CTA,术后患者1、3、6、12个月定期随访,复查踝肱指数(ankle-brachial index, ABI)、下肢血管彩超或下肢动脉计算机断层扫描血管造影(computed tomographic angiography, CTA),观察临床症状改善及病变血管通畅情况。结果 AngioJet机械血栓抽吸术组和下肢动脉切开取栓术组在性别、年龄、糖尿病史、吸烟史、冠心病史、房颤病史、脑梗死病史、高血压病史等高危因素的比较中无明显差异(P>0.05);两组术后并发症中血红蛋白尿分别为24例和3例,具有明显差异(P<0.05),在消化道出血、房颤、血栓再形成和切口感染并发症中两组无明显差异(P>0.05);术后1个月、3个月、6个月,AngioJet机械血栓抽吸术组患肢通畅率分别为75.00%、65.62%、56.25%,下肢动脉切开取栓术组患肢通畅率分别为44.44%、33.33%、16.78%,两组之间有显著统计学差异(P<0.05),而在术后12个月,两组患者通畅率分别为31.25%和11.11%,无明显统计学差异(P>0.05)。结论 AngioJet机械血栓抽吸术治疗ASOCAT可以快速清除血栓,减少溶栓药物使用量,具有较好的临床使用价值。Objective To investigate the clinical effectiveness of Angiojet mechanical thrombus aspiration and lower extremity artery incision thrombectomy through a retrospective study.Methods The clinical data of 42 patients diagnosed with arteriosclerosis obliterans complicat⁃ed with acute thrombosis(ASOCAT)were retrospectively analyzed.These patients were admit⁃ted to the interventional vascular surgery ward of the Fourth Affiliated Hospital of Harbin Medi⁃cal University between January 2020 and February 2022.The patients was divided into two groups:the Angiojet mechanical thrombus aspiration group(n=26)and the lower extremity arteriotomy thrombectomy group(n=16).In the Angiojet mechanical thrombus aspiration group,patients underwent aspiration of lower extremity arterial thrombus using the Angiojet thrombus suction catheter.Conversely,in the lower extremity arteriotomy thrombectomy group,thrombus removal was achieved through the use of a Fogarty balloon thrombectomy catheter fol⁃lowing incision of the femoral artery.Prior to surgery,all patients underwent a comprehensive set of routine examinations,including blood cell analysis,biochemical profiling,coagulation tests,urine analysis,vectorcardiogram,color Doppler ultrasound of the heart,and imaging of lower extremity blood vessels via color Doppler ultrasound or computed tomographic angiography(CTA).Postoperative follow⁃up was conducted at 1,3,6,and 12 months,with assessments including ankle⁃brachial index(ABI)measurements and repeat imaging to evaluate clinical im⁃provement and vascular patency.Results No significant differences were found in gender,age,history of diabetes,smoking,coronary heart disease,atrial fibrillation,cerebral infarc⁃tion,hypertension,or other high⁃risk factors between the two groups(P>0.05).Hemoglo⁃binuria was found in 24 cases,with a significant difference between the two groups(P<0.05).Postoperative complications occurred in 3 cases,but there were no significant differ⁃ences in gastrointestinal bleeding,atrial fibrillation,

关 键 词：下肢动脉硬化闭塞症 血栓形成 下肢动脉切开取栓术 机械血栓清除术 

分 类 号：R543.6[医药卫生—心血管疾病]