超声引导下注射不同剂量凝血酶治疗血管介入诊疗术后股动脉假性动脉瘤的临床观察Clinical observation of ultrasound guided injection different dosage of thrombin for treatment of iatrogenic femoral artery pseudoaneurysm
唐其柱,马可忠,朱锐,刘文卫
摘要(Abstract):
目的探讨超声引导下注射不同剂量凝血酶治疗血管介入诊疗术后股动脉假性动脉瘤的疗效和不良反应。方法将48例于襄阳市中心医院行血管介入术后形成股动脉假性动脉瘤的患者随机分为两组,观察组注射凝血酶液为100 U/ml,对照组注射凝血酶液为500 U/ml,在超声引导下于瘤腔内注射凝血酶。结果观察组和对照组患者特征、注射凝血酶次数及操作时间差异无统计学意义,观察组有1例术后1天复发,对照组全部成功。对照组有2例发生股浅动脉栓塞,1例术后1周内有低热,观察组无不良反应发生。结论在超声引导下注射凝血酶治疗血管介入诊疗术后股动脉假性动脉瘤,小剂量注射凝血酶同样有效,而且可能降低注射凝血酶的风险。
关键词(KeyWords): 假性动脉瘤;超声监测;凝血酶
基金项目(Foundation):
作者(Author): 唐其柱,马可忠,朱锐,刘文卫
参考文献(References):
- [1]Szendro G,Golcman I,Klimov A,et al.Arterial false anenrysm and their modern management.Isr Med Assoc J,2001,3:5-8.
- [2]金毕,李毅清,赖传善,等.创伤性周围假性动脉瘤的外科治疗分析.临床外科杂志,2004,12:346-347.
- [3]Freund G,Dtirschmied D,Zhou Q,et al.Occlusion of iatmgenic pseudoaneurysms with percutaneous ultrasound guided thrombin injection.Vasa,2007,36:96-99.
- [4]朱锐,马可忠,刘文卫,等.超声引导下注射小剂量凝血酶治疗股动脉假性动脉瘤的临床体会.中国心血管病研究,2008,6:190-191.
- [5]Katzenschlager R,Ugurluoglu A,Ahmadi A,et al.Incidence of pseudoaneurysm after diagnostic and therapeutic angiography.Radiology,1995,195:463-466.
- [6]覃军,黄岚,李爱民,等.超声波引导下压迫法与注射凝血酶法治疗心导管术后股动脉假性动脉瘤的比较.临床心血管病杂志,2004,20:485-488.
- [7]Paulson EK,Sheafor DH,Kliewer MA,et al.Treatment of iatrogenie femoral arterial pseudoaneurysms:comparison of US-guided thrompin injection with compression repair.Radiology,2003,5:403.
- [8]Lennox AF,Delis KT,Szendro G,et al.Duplex-guided thrombin injection for iatrogenic femoral artery pseudoaneurysm is effective even in anticoagulated patients.Br J Surg,2000,87:796-801.
- [9]Middleton WD,Dasyam A,Teefey SA.Diagnosis and treatment of iatrogenic femoral artery pseudoaneurysms.Ultrasound-Q,2005,21:3-17.
- [10]Krueger K,Zaehringer M,Strohe D,et al.Postcatheteri-zation pseudoaneurysm:results of US-guided percutaneous thrombin injection in 240 patients.Radiology,2005,236:1104.
- [11]McCoy D,Scharfstein B,Walker W,et al.Ultrasound-guided percutaneous thrombin injection for femoral artery pseudoaneurysms.Am Surg,2000,66:975-977.