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超声引导下瘤腔内注射凝血酶治疗股动脉假性动脉瘤的临床研究

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超声引导下瘤腔内注射凝血酶治疗股动脉假性动脉瘤的临床研究

作者:汪凡

来源:《中国医学创新》2014年第17期

【摘要】目的:评价超声引导下瘤内注射凝血酶治疗股动脉假性动脉瘤的应用价值。方法:入选33例经皮冠脉介入治疗术后形成的股动脉假性动脉瘤患者。采用超声引导下,于超声探头压迫瘤颈同时,瘤腔内注射凝血酶(浓度为100 U/mL)。分析假性动脉瘤的类型、大小、瘤径长度及宽度、凝血酶用量及其疗效,观察其并发症。结果:33例患者中,单纯型25例,复杂型8例。动脉瘤平均体积为(9.0±5.0) cm3,瘤颈部宽度(2.7±0.7)mm,颈部长度(5.9±0.9)mm,平均凝血酶用量(299±110)U。30例一次成功,3例第一次注射后复发,经第二次注射后成功,其中单纯型1例,复杂型2例。未发生动脉或静脉栓塞等并发症。术后随访3个月无复发。与单纯型相比,复杂型动脉瘤患者年龄更大,女性更多,体重指数及瘤腔体积更大,所需凝血酶剂量更多(P0.05)。结论:超声引导下瘤腔内注射凝血酶治疗股动脉假性动脉瘤操作简便,疗效好,安全性高,可作为介入术后股动脉假性动脉瘤的首选治疗方法。

【关键词】彩色多普勒超声;假性动脉瘤;凝血酶

【Abstract】 Objective:To evaluate the value of ultrasound-guided thrombin injection for femoral arterial pseudoaneurysms(PSA). Method:33 patients with femoral arterial pseudoaneurysms caused by coronary interventions were studied. After the tumor necks were compressed with ultrasound probes,thrombins were injected into the tumor cavities. The concentration of thrombin was 100 U/mL. The size and type of the PSA, length and width of PSA neck,thrombin dose, therapy outcome and complication were analyzed. Result:In 33 patients,25 were simple PSA, and 8 were complex PSA. mean volume of PSA was (9.0±5.0)cm3,mean width and length of PSA neck was (2.7±0.7)mm and (5.9±0.9)mm, respectively. Mean thrombin dose was (299±110)U. The success rate of the first injection was 90.9%. 3 patients had PSA recurrence after the first injection, but were cured after the second injection. No thromboembolic complications or infections occurred.All patients were successfully treated at the first time. No complication occurred during or after the operations, and no recurrence was found in a three-month follow-up. There was different significantly in the age,sex,body weight index and mean volume of PSA in two groups(P0.05). Conclusion:Ultrasound-guided thrombin injection is easy,safe and effective. It should be the initial treatment of choice for patients with postcatheterization pseudoaneurysms.

【Key words】 Color doppler echo; Pseudoaneurysm; Thrombin