AngioJet药物机械偶联血栓清除术治疗急性下肢深静脉血栓形成

目的 探讨AngioJet药物机械偶联血栓清除术治疗急性下肢深静脉血栓形成(DVT)的效果与并发症.方法 回顾性分析2015年2月至2016年8月通过AngioJet药物机械偶联血栓清除术治疗的22例急性下肢DVT患者临床资料,依据患者术后临床症状缓解情况及血栓清除率评估治疗效果,观察手术相关并发症发生情况.结果 22例患者术后症状即刻缓解,患健肢大腿周径差由术前(4.5±0.6) cm下降至术后(1.0±0.4) cm(P＜0.05).尿激酶平均剂量(18.4±3.1)万U,平均溶栓时间(4.2±0.7)h.19例DVT完全清除(＞90％),2例大部分清除(50％～90％),1例部分清除(＜50％).术后6例患者出现短暂性血红蛋白尿,经补液水化后当日缓解,无肺栓塞、大出血等并发症发生.结论 AngioJet药物机械偶联血栓清除术治疗急性下肢DVT安全有效,并发症少.

AngioJet rheolytic thrombectomy for the treatment of acute deep venous thrombosis of lower extremity

Objective To discuss the efficacy and complications of using AngioJet rheolytic thrombectomy in treating acute lower extremity deep vein thrombosis (DVT).Methods The clinical data of 22 patients with acute lower extremity DVT,who were treated with AngioJet rheolytic thrombectomy during the period from February 2015 to August 2016,were retrospectively analyzed.The improvement of clinical symptoms and the thrombus clearance rate were calculated to evaluate the curative effect.The procedure-related complications were documented.Results The clinical symptoms were relieved immediately after operation in all 22 patients.The thigh circumference difference between the affected side and the healthy side decreased from preoperative (4.5±0.6) cm to postoperative (1.0±0.4) cm,the difference in change was statistically significant (P＜0.05).The mean used dose of urokinase was (0.18±0.03) million unit and the average duration of thrombolysis was (4.2±0.7) hours.Complete removal of DVT (＞90％) was achieved in 19 patients,most removal of DVT (50％-90％) in 2 patients,and partial removal of DVT (＜50％) in one patient.After treatment,6 patients developed transient hemoglobinuria,which was relieved after hydration with fluid infusion on the same day.No serious complications such as pulmonary embolism or hemorrhage occurred.Conclusion For the treatment of acute lower extremity DVT,AngioJet rheolytic thrombectomy is safe and effective with less complications.