彩超引导下注射凝血酶联合瘤颈压迫治疗股动脉假性动脉瘤的临床价值

目的:探讨彩超引导下瘤腔内注射凝血酶联合瘤颈压迫治疗股动脉假性动脉瘤的临床价值。方法:对15例经彩超确诊为股动脉假性动脉瘤的患者,在彩超引导下压迫假性动脉瘤颈阻断股动脉与瘤腔间的瘘道,并保持股动脉远端血流通畅,同时使用21G细针远离瘤颈部穿刺瘤腔,缓慢注入凝血酶封闭治疗,瘤腔内彩色血流信号消失提示注射治疗成功。结果:15例股动脉假性动脉瘤在彩超引导下压迫瘤颈联合凝血酶注射后彩超显示瘤腔即刻闭合,14例一次性获得成功;1例由于瘤腔较大及大量运用抗凝药治疗,于24h后彩超复查发现瘤腔小部分复发,行第2次凝血酶注射治疗成功,总成功率达100%。结论:彩超引导下瘤腔内注射凝血酶联合瘤颈压迫治疗股动脉假性动脉瘤安全、有效、可重复性强,具有重要的临床应用价值。

Treating femoral pseudoaneurysm with thrombin injection under neck fistula blockage of pseudoaneurysm cavity guided by color doppler flow image

Objective： To investigate the efficacy of thrombin injection combing with pseudoaneu rysm neck pressing under the guidance of color doppler flow image （CDFI） for femoral pseudoaneurysm. Methods： A total of 15 CDFI confirmed femoral pseudoaneurysms patients underwent the following treatment： Block fistula between pseudoaneurysm cavity and femoral artery under the guidance of CDFI while maintain the distal femoral artery blood flow, then puncture the pseudoaneurysm cavity with 21 G needle to infuse thrombin until the color doppler signals disappeared which indicated successful injection. Results： The procedure was successful in all cases except one failure due to huge pseudoaneurysm cavity and large dose of injected thrombin, in which partial cavity was shown again 24 hours after the treatment, but the second procedure was successful, made the successful rate of 1005. Conclusions： Thrombin injection to the pseudoaneurysm cavity when the fistula between pseudoaneurysm cavity and femoral artery is blocked under the guidance of CDFI is safe, effective and repeatable.