殷世武,潘升权,项廷淼,龙海灯,李靖,张惠林,张慧敏,王菊.超声引导下顺行静脉穿刺联合Angiojet血栓抽吸治疗下肢深静脉血栓[J].中国介入影像与治疗学,2020,17(9):528-532
超声引导下顺行静脉穿刺联合Angiojet血栓抽吸治疗下肢深静脉血栓
Ultrasound-guided antegrade vein puncture followed by Angiojet thrombosis aspiration for treatment of lower extremity deep vein thrombosis
投稿时间:2020-03-03  修订日期:2020-07-30
DOI:10.13929/j.issn.1672-8475.2020.09.004
中文关键词:  静脉血栓形成  下肢  腔静脉滤器  超声检查
英文关键词:venous thrombosis  lower extremity  vena cava filters  ultrasonography
基金项目:合肥市卫计委应用医学项目(hwk2016zc007)。
作者单位E-mail
殷世武 安徽医科大学附属合肥医院介入血管科, 安徽 合肥 230011 yinshiwu@126.com 
潘升权 安徽医科大学附属合肥医院介入血管科, 安徽 合肥 230011  
项廷淼 安徽医科大学附属合肥医院介入血管科, 安徽 合肥 230011  
龙海灯 安徽医科大学附属合肥医院介入血管科, 安徽 合肥 230011  
李靖 安徽医科大学附属合肥医院介入血管科, 安徽 合肥 230011  
张惠林 安徽医科大学附属合肥医院介入血管科, 安徽 合肥 230011  
张慧敏 安徽医科大学附属合肥医院介入血管科, 安徽 合肥 230011  
王菊 安徽医科大学附属合肥医院介入血管科, 安徽 合肥 230011  
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中文摘要:
      目的 观察超声引导顺行静脉穿刺联合Angiojet血栓抽吸治疗下肢深静脉血栓(DVT)的效果。方法 回顾性分析63例急性期和亚急性期下肢DVT患者,均经下肢深静脉造影诊断后置入下腔静脉滤器,并接受超声引导下Angiojet血栓抽吸及置管溶栓术,观察疗效及安全性。结果 63例中,54例置入可回收滤器,9例置入永久性滤器;可回收滤器回收率为88.89%(48/54),平均回收时间(5.48±2.10)天。超声引导下顺行穿刺静脉成功率100%(66/66),无穿刺并发症;治疗DVT效果优良率为84.13%(53/63)。抽吸血栓后9例出现血红蛋白尿,溶栓过程中7例出现黏膜出血,并发症发生率为25.40%(16/63),无严重并发症发生。术后随访(22.74±6.21)个月,7例失访,1例死于恶性肿瘤,6例(6/55,10.91%)发生血栓后综合征。结论 超声引导下顺行静脉穿刺联合Angiojet血栓抽吸治疗下肢深静脉血栓安全有效。
英文摘要:
      Objective To observe the therapeutic effect of Angiojet thrombosis aspiration of lower extremity deep vein thrombosis (DVT) after ultrasound-guided antegrade vein puncture. Methods Data of 63 patients with acute or subacute lower extremity DVT were retrospectively analyzed. Angiography of the lower extremity was followed by implantation of inferior vena cava filter. Ultrasound-guided Angiojet thrombosis aspiration and transcatheter thrombolysis were performed, and the effect and safety were observed. Results Among 63 patients, 54 recycled filters and 9 permanent filters were implanted. The recovery rate of recycled filters was 88.89% (48/54), and the average recovery time was (5.48±2.10) days. The success rate of ultrasound-guided antegrade vein puncture was 100% (66/66) without complication. The excellent and good treatment rate was 84.13% (53/63). There were 9 cases of hemoproteinuria after thrombus aspiration and 7 cases of mucosal hemorrhage during thrombolysis, and the total incidence of complications was 25.40% (16/63). No serious complication occurred. During (22.74±6.21) months' follow-up, 7 cases were lost and 1 case died due to malignant tumor, and post-thrombotic syndrome occurred in 6 cases (6/55, 10.91%). Conclusion Ultrasound-guided anterograde vein puncture combined with Angiojet thrombosis aspiration is effective and safe for treatment of lower extremity deep vein thrombosis.
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