凝血酶栓塞治疗冠脉介入术后股动脉假性动脉瘤疗效观察.docVIP

凝血酶栓塞治疗冠脉介入术后股动脉假性动脉瘤疗效观察 凝血酶栓塞治疗冠脉介入术后股动脉假性动脉瘤疗效观察 作者：童国新，王宁夫，叶显华，方建华，杨建敏，潘 浩，徐 坚，周 亮 作者单位：杭州市第一人民医院，浙江杭州 310006 【摘要】 目的 探讨瘤腔内注射凝血酶治疗股动脉假性动脉瘤的疗效和安全性。方法 2006年1月至2008年4月心脏冠脉介入术后并发股动脉假性动脉瘤的患者，共33例,其中男12例,女21例,年龄58～72岁,平均66±16岁。其中8例选择性冠状动脉造影术，25例经皮冠状动脉内血管成形术。所有患者均使用GE LOGIQ 9彩色多普勒超声仪确诊，并在超声引导下进行瘤腔内注射凝血酶栓塞治疗。结果 5例先行股动脉压迫治疗，无效后改用凝血酶注射栓塞治疗，其余28例首选超声引导下瘤腔内注射凝血酶栓塞治疗。其中31例一次性栓塞成功，2例经2次栓塞成功,总成功率100％。凝血酶用量200～800u。1例出现血管迷走性晕厥，12例患者注射凝血酶后均有体温轻度升高，自行好转。无动脉栓塞及静脉血栓形成、无凝血酶过敏表现、感染、出血等并发症。结论 超声引导下瘤腔内注射凝血酶的治疗方法可缩短患者住院时间、花费少，而且简单、安全、成功率高，可作为治疗心脏冠脉介入术后假性动脉瘤的首选方法。 【关键词】 假性动脉瘤；凝血酶；冠状动脉；介入;导管 Ultrasound_guided Thrombin Injection for the Treatment of Coronary Intervention_related Femoral Pseudoaneurysm. TONG Guo_xin, WANG Ning_fu, YE Xian_hua，et al. Department of Cardiology, the First Peoples Hospital of Hangzhou, Zhejiang 310006, China. ［Abstract］ Objective To evaluate the effectivity and safety of ultrasound_guided percutaneous thrombin injection for the treatment of postcatheterization femoral pseudoaneurysm. Methods From January 2006 to April 2008, 33 patients(12 male, 21 female, age range 58～72 years, mean 66 years) were found to have pseudoaneurysmes associated with catheterization procedure, and 8 of them with diagnostic angiography，the other 25 patients with stent implantation. Results Thrombin was injected directly into the pseudoaneurysm with dosage 200～800 units over several seconds. Successful ablation was visualized immediately in 31 patients. The other 2 patients needed two thrombin injections and compression treatment of 2～3 minutes. The total success rate of ablating pseudoaneurysm was 100%. One patient had vasovagal syncope, 12 patients had mild fever after thrombin injection. No distal embolization, infection, hemorrhage or allergic reaction occurred. Conclusions Ultrasound_guided thrombin injection may shorten hospitalization duration and it is a safe, simple, inexpensive and effective non_invasive method for the treatment of postca