AngioJet血栓清除装置治疗急性下肢深静脉血栓形成初步临床应用

Clinical application of thrombus removal device AngioJ et in treating acute lower extremity deep venous thrombosis: preliminary results

【摘要】目的探讨AngioJet血栓机械性清除装置治疗急性下肢深静脉血栓形成（DVT）的效果和安全性。 方法回顾性分析2014年7月至2015年10月收治的55例急性下肢DVT患者临床资料,其中23例接受AngioJet血栓清除装置治疗（A组）,32例接受置管溶栓治疗（B组）。评价两组患者治疗期间应用尿激酶总量、溶栓时间、住院时间、消肿率及并发症发生情况。 结果A、B组患者尿激酶总用量分别为（106.09±61.92）×104 U、（204.38±108.27）×104 U,溶栓时间分别为（3.00±2.35） d、（5.11±2.57） d,住院时间分别为（7.39±0.94）d、（9.19±2.26）d,差异均有统计学意义（P值分别为0.001、0.003、0.001）；患肢消肿率分别为（76.60±19.07）%、（73.59±25.22）%,并发症发生率分别为4.35%（1/23）、6.25%（2/32）,差异无统计学意义（P值均＞0.05）。 结论AngioJet血栓机械性清除装置治疗急性下肢DVT可明显提高血栓清除效率,减少尿激酶用量,缩短药物溶栓时间及住院治疗时间,且疗效良好,值得临床上进一步推广应用。

Objective To investigate the effect and safety of AngioJet Ultra thrombectomy system, a thrombus removal device, in treating acute deep venous thrombosis （DVT） of lower extremity. Methods The clinical data of 55 patients with acute DVT of lower extremity, who were admitted to authors＇ hospital during the period from July 2014 to October 2015, were retrospectively analyzed. Of the 55 patients, AngioJet Ultra thrombectomy system was employed in 23 （group A） and catheter-directed thromlysis （CDT） was adopted in 32 （group B）. During the treatment, the total used amount of urokinase, thrombolysis time, hospitalization time, swelling regression rate and occurrence of complications were evaluated. Results In group A and group B, the total used dosages of urokinase were （ 106.09 ± 61.92） × 104 U and （ 204. 38 ± 108.27） × 104 U respectively, the thrombolysis days were （ 3.00 ± 2.35 ） days and （ 5.11 ±2.57 ） days respectively, and the hospitalization days were （7.39±0.94） days and （9.19±2.26） days respectively; the differences in the above indexes between the two groups were statistically significant （P= 0.001, P= 0.003 and P= 0.001 respectively） ; while in group A and group B the swelling regression rates were （ 76.60 ±19.07 ） % and （ 73.59 ±25.22 ） % respectively, and the occurrences of complications were 4.35% （1/23） and 6.25% （2/32） respectively, the differences between the two groups were not statistically significant （both P 〉 0.05 ）. Conclusion For the treatment of acute DVT of lower extremity, the utilization of AngioJet Ultra thrombectomy systemcan significantly improve thrombolytic efficiency, reduce the used amount of urokinase, and shorten the thrombolytic time as well as hospitalization time. This technique has satisfactory clinical effect, therefore, it is worthy of further popularization in clinical practice.