摘要
目的分析经皮机械性血栓清除术(PMT)治疗急性下肢动脉缺血患者的疗效及短期预后。方法回顾性分析2019年1月至2021年7月本科收治的74例下肢动脉缺血患者,其中40例接受AngioJet机械性血栓抽吸治疗(PMT组),34例接受单纯导管接触溶栓治疗(CDT组),比较两组患者尿激酶用量、溶栓时间、住院时间、住院费用、术后相关并发症和术后1个月内通畅率及病死率发生情况,SF⁃36评分表比较两组术前术后生活质量情况。结果两组手术治疗有效率均为100%。CDT组、PMT组的尿激酶用量分别为(137.41±47.02)×10^(4)、(58.35±39.83)×10^(4)U,溶栓时间分别为(35.85±11.60)、(22.30±11.82)h,住院时间分别为(10.31±2.9)、(8.55±2.11)d,住院费用分别为(3.32±1.12)×10^(4)、(5.22±0.89)×10^(4)元,出血及穿刺出血的发生率分别为17.6%、2.5%,SF⁃36评分中,术后两天躯体疼痛分别为(53.86±13.89)、(63.02±10.39),情感职能分别为(58.04±10.32)、(63.61±13.19),差异有统计学意义(P<0.05);PMT组两组中术后1个月内通畅率(88.2%vs.90.0%)、病死率(3.0%vs.5.0%),差异均无统计学意义(P>0.05)。结论在急性下肢动脉缺血的治疗中,AngioJet在保证与CDT具有相同疗效的同时,还可以显著减少术后出血以及穿刺点血肿、住院时间、手术费用,提高患者术后生活质量。
Objective To analyze the curative effect and short⁃term effect of percutaneous mechanical thrombectomy(PMT)in patients with acute lower extremity arterial ischemia.Methods A retrospective analysis was performed on 74 patients with lower extremity arterial ischemia who were admitted to our department from Janu⁃ary 2019 to July 2021.Among them,40 were treated with Anjiojet mechanical thrombus aspiration system(PMT group),and 34 with catheter⁃directed thrombolysis(CDT group).The dosage of urokinase,thrombolysis time,hospitalization time,hospitalization cost,postoperative complications,and the incidence of patency and mortality within one month after surgery were compared between the two groups,and 36⁃item short⁃form health survey(SF⁃36)was used to compare the quality of life between CDT group and PMT group.Results The effective rate of surgical treatment in both groups was 100%.The dosage of urokinase in the CDT group and PMT group was(137.41±47.02)×10^(4) U and(58.35±39.83)×10^(4) U;thrombolysis time was(35.85±11.60)h and(22.30±11.82)h;hospitalization time was(10.31±2.9)days and(8.55±2.11)days;hospitalization expenses were(3.32±1.12)ten thousand yuan and(5.22±0.89)ten thousand yuan and the incidence of bleeding and puncture bleeding were 17.6%and 2.5%,respectively.SF⁃36 showed that the score of body pain was(53.86±13.89)and(63.02±10.39),and that of emotional function(58.04±10.32)and(63.61±13.19)respectively in the two consecutive days after the operation,and the differences were statistically significant(P<0.05).There was no significant difference in patency rate(88.2%vs.90.0%)and fatality rate(3.0%vs.5.0%)within one month(P>0.05).Conclusion In the treatment of acute lower extremity arterial ischemia,AngioJet can significantly reduce postoperative bleeding and puncture point hematoma,shorten hospitalization time,and reduce operation cost while ensuring the same efficacy as CDT,and improve the quality of life of patients after operation.
作者
刘洋
何春水
张丽峰
曾伟
林瑶
耿彩娟
王科
王奇奇
黄伟
魏海军
LIU Yang;HE Chunshui;ZHANG Lifeng;ZENG Wei;LIN Yao;GENG Caijuan;WANG Ke;WANG Qiqi;HUANG Wei;WEI Haijun(Department of Vascular Surgery,Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610039,China)
出处
《实用医学杂志》
CAS
北大核心
2022年第10期1255-1259,共5页
The Journal of Practical Medicine
基金
四川省中医药管理局科研课题(编号:2021MS204)。
