彩色多普勒超声在诊治经皮腔内介入术后并发症中.docVIP

超声在经皮腔内介入术后股动脉穿刺相关并发症中的诊治作用，杜文华，王孝君，杨未晓，熊秀勤，刘力嘉，王翔，何佳颖（第三军医大学大坪医院野战外科研究所超声诊断科，重庆400042） 摘 要：目的 探讨彩色多普勒超声在诊治经皮腔内介入术后股动脉穿刺相关并发症中的作用。 方法 对39例经皮腔内动脉介入术后股动脉穿刺处出现临床症状的患者彩色多普勒超声的超声图像以及在超声引导下治疗的结果进行回顾性分析,总结彩色多普勒超声在诊治经皮腔内介入术后股动脉穿刺相关并发症中的作用。 结果 经彩色多普勒超声诊断39例中主要并发症为：假性动脉瘤形成16例，穿刺血管周围组织水肿11例，穿刺血管周围血肿17例，动静脉瘘形成4例，11例同时具有2种或2种以上的并发症。彩色多普勒超声的引导下定点压迫，4例假性动脉瘤、3例动静脉瘘经加压24~72h后动静脉分流消失，杂音消失，1例动静脉瘘定点压迫无明显改善，后经导管植入覆膜支架修补；采用超声引导下注射凝血酶治疗假性动脉瘤12例，其中10例24h后动静脉分流消失，1例48h后再次注射凝血酶加压包扎24h动静脉分流消失，1例经过3次注射凝血酶加压包扎24h动静脉分流消失 结论 彩色多普勒超声在诊断与超声引导下治疗经皮腔内介入术后股动脉穿刺点相关并发症中具有重要作用。 关键词：彩色多普勒；介入性；并发症；假性动脉瘤；动静脉瘘；治疗 Evaluation of complication correlating with puncture of femoral artery after percutaneous transluminal interventional procedure with color Doppler ultrasound Li Tao, Du Wen-hua, Wang Xiao-jun, Yang Wei-xiao, Xiong Xiu-qin, Liu Li-jia, Wang Xiang, He jia-ying(Department of Ultrasound Diagnosis, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing 400042, China) Abstract: Objective To evaluate the effect of color Doppler ultrasound in the diagnosis and treatment for the complication correlating with puncture of femoral artery after percutaneous transluminal interventional procedure. Methods The image of Doppler and the results of treatment with the guide of Doppler of thirty-nine cases with complication correlating with puncture of femoral artery after percutaneous transluminal interventional procedure were retrospectly studied and to summarize the effect of color Doppler ultrasound in the diagnosis and treatment for the complication correlating with puncture of femoral artery after percutaneous transluminal interventional procedure. Results The complication correlating with puncture of femoral arter in thirty-nine cases included pseudoaneurysm in sixteen cases, edema of tissue around the artery in eleven, hematoma in seventeen and formation of arteriovenous fistula in four. There were eleven cases with mutiple complication. After pressure of the point of