超声引导下注射凝血酶治疗医源性股动脉假性动脉瘤的临床观察

Clinical Observation on the Ultrasound-guided Thrombin Injection in the Treatment of Postcatheterization Pseudoaneurysms

目的:评价超声引导下注射凝血酶治疗股动脉假性动脉瘤的安全性和疗效。方法:选择2011年5月至2012年10月在我院行冠状动脉介入治疗术后出现股动脉假性动脉瘤的患者共13例,其中男性5例,女性8例,年龄平均70.2±5.6岁。所有患者均植入冠状动脉支架,术后1-3天经彩色超声明确诊断为股动脉假性动脉瘤,首先采用压迫法治疗无效,在超声实时引导下,利用穿刺架精确定位,18G PTC针穿刺假性动脉瘤,瘤体内分次注射凝血酶100-400IU的方法治疗。结果:13例患者利用凝血酶注射封堵法均成功治愈股动脉假性动脉瘤,其中8例注射1次成功,另外5例注射2次成功,未发生过敏、血栓形成、感染及出血等并发症。次日及出院前复查超声无复发病例,随访3个月至1年未再复发。结论:超声引导下注射凝血酶治疗股动脉假性动脉瘤具有微创、快速、经济、安全、疗效确切、复发率低的优点,值得临床进一步研究和推广。

Objective： To assess the safety and efficacy of Ultrasound-guided thrombin injection in the treatment of postcatheterization pseudoaneurysms.Methods： From May 2011 to October 2012,13 cases of iatrogenic pseudoaneurysm patients（5 males,8 females,average aged at 70.2 ±5.6） who were admitted in our hospital were selected and injected with thrombin under the guidance of ultrasound.The most superficial pseudoaneurysm chamber was entered with an 18 GTC needle.And thrombin,in a 100-400IU,was injected into the chamber.Results： Ultrasound-guided thrombin injection was successful in all patients.8 patients were just injected once and 5 patients were injected twice.No arterial thrombotic events occurred.Conclusion： Ultrasound-guided thrombin injection was safe and effective in the treatment of patients with postcatheterization pseudoaneurysms.