超声在诊治医源性股动脉假性动脉瘤中的应用

The application of ultrasound in the diagnosis and treatment of iatrogenic femoral arterial pseudoaneurysms

目的评价超声对医源性股动脉假性动脉瘤的诊断价值及超声引导下压迫治疗假性动脉瘤、注射凝血酶治疗假性动脉瘤的疗效。方法应用二维超声、彩色多普勒、频谱多普勒对28例股动脉穿刺术后临床疑诊为股动脉假性动脉瘤的患者进行检查,并在超声引导下进行压迫治疗,治疗失败者改为局部瘤腔内注射凝血酶治疗。结果28例中彩超诊断假性动脉瘤25例,3例阴性患者经临床观察排除假性动脉瘤,彩超诊断与临床符合率100%。彩超引导下压迫治疗假性动脉瘤,24例治愈,1例失败后改为瘤腔内注射凝血酶治愈。结论超声能无创、敏感地诊断股动脉假性动脉瘤,超声引导下压迫是治疗假性动脉瘤的简便、安全、可靠的方法,失败者可进行注射凝血酶等其他手段治疗。

Objective To assess the value of the application of ultrasound in the diagnosis of iatrogenic femoral arterial pseudoaneurysm and the efficacy of repairing the femoral arterial pseudoaneurysm by compression or thrombin injection under sonographic guidance. Methods 28 patients who have been suspected to have femoral arterial pseudoaneurysm after femoral artery catheterized were checked by high and low frequency probe of Philips 4500 using 2 - D ultrasound,color Doppler and spectral Doppler imaging. The patients with pseudoaneurysm were treated by ultrasound guided compression. For the patiemts who failed, thrombin was injected in the mass. Results 25 cases were diagnosed by ultrasound in all 28 patients.3 false patients were excluded by ultrasound and clinical finding. The rate of conformity with their clinical finding was 100%. 24 patients were cured by ultrasound- guided compression repair （UGCR） .One failed patient was cured by thrombin injection in the mass. Conclusion Ultrasound can diagnose the femoral arterial pseudoaneurysm non - invasively and sensitively. UGCR is a simple, safe and effective method. The failer can be cured by thrombin injection and other methods.