摘要
目的探讨超声引导下注射凝血酶治疗股动脉假性动脉瘤的方法及临床疗效。方法回顾性分析2017年1月至2019年12月在唐山市工人医院行超声引导下注射凝血酶治疗股动脉假性动脉瘤患者71例。根据假性动脉瘤瘤颈形态分成两组:其中瘘管型55例,裂隙型16例。分别测量并记录瘤腔最大径线、瘤颈直径。两组均采用超声引导下注射凝血酶(根据瘤颈形态采用不同注药方法),首次治疗及复发后二次治疗均采用常规注药方法,对于2例裂隙型二次复发患者,第三次注药时采用交叉注射、向瘤颈逐渐推进的方法,并在瘤腔内血流信号消失后适当延长加压时间。术后24 h、1周复查超声,观察瘤腔内血流及血栓形成情况。结果55例瘘管型假性动脉瘤患者中54例一次注药成功,1例术后24 h复查超声发现复发,第二次注药成功;16例裂隙型假性动脉瘤患者中10例一次注药成功,6例术后24 h复查超声发现复发,4例第二次注药成功,2例第三次注药成功。瘘管型假性动脉瘤的复发与瘤颈直径大小无相关性(rs=0.103,P=0.455),而裂隙型假性动脉瘤的复发与瘤颈直径大小密切相关(rs=0.870,P<0.001)。最终所有患者均取得满意疗效,治愈率100%。结论超声引导下注射凝血酶治疗股动脉假性动脉瘤临床疗效显著,但术前需通过超声检查明确瘤颈形态、测量瘤颈直径,以便采用合理有效的注药方法,提高首次治疗成功率,减少复发。
Objective To investigate the method and clinical effect of ultrasound-guided thrombin injection in the treatment of femoral pseudoaneurysm.Methods From January 2017 to December 2019,71 patients in Gongren Hospital with femoral pseudoaneurysm were treated by ultrasound-guided thrombin injection.There were 55 cases of fistula type and 16 cases of fissure type.The maximum diameter of the cavity and the neck of pseudoaneurysm were measured and recorded.Two groups of patients were injected thrombin under ultrasound guidance(according to the shape of the pseudoaneurysm neck,different injection methods were used).The treatments for the first time and first recurrence of the two groups were treated with the corresponding conventional injection method.For the second fracture type of the second recurrence of the patients,the method of cross injection and gradual advance to the pseudoaneurysm neck was used for the third time,and the compression time was extended after the blood flow in the cavity disappeared.Ultrasound was performed at 24 hours and 1 week after operation to observe the blood flow and thrombosis.Results In 55 patients with pseudoaneurysm of fistula type,54 patients were treated successfully after once injected,pseudoaneurysm recurred in 1 patient relapsed by ultrasound 24 hours after operation,and the second injection was successful.In 16 patients with pseudoaneurysm of fissure type,10 patients were successfully treated after once injection,6 patients recurred 24 hours after operation,4 patients were successfully treated after the second injection,and 2 patients after the third injection.There was no correlation between the recurrence of fistula pseudoaneurysm and the diameter of the pseudoaneurysm neck(rs=0.103,P=0.455),while the recurrence of fissure pseudoaneurysm was closely related to the diameter of the pseudoaneurysm neck(rs=0.870,P<0.001).Finally,all the patients achieved satisfactory curative effect,and the cure rate was 100%.Conclusions Ultrasound-guided thrombin injection in the treatment of femoral pseudoaneurysm has a significant clinical effect.However it is necessary to determine the shape of the pseudoaneurysm neck and measure the diameter of the pseudoaneurysm neck before operation,so as to adopt a reasonable and effective injection method,to improve the success rate of the first treatment and reduce the recurrence.
作者
董涛
王庆文
韩泽朝
陈鹏
颜慧珊
Dong Tao;Wang Qingwen;Han Zechao;Chen Peng;Yan Huishan(Department of Ultrasound Diagnostis,Tangshan Gongren Hospital,Tangshan 063000,China)
出处
《中华超声影像学杂志》
CSCD
北大核心
2020年第9期794-798,共5页
Chinese Journal of Ultrasonography
关键词
超声引导
假性动脉瘤
凝血酶
瘤颈
Ultrasound-guided
Pseudoaneurysm
Thrombin
Tumor neck
