AngioJet机械血栓清除术后血红蛋白尿的原因分析

Causes of hemoglobinuria after AngioJet mechanical thrombectomy

目的探讨采用AngioJet进行机械血栓清除术后出现血红蛋白尿的原因及影响因素。方法回顾性分析接受AngioJet机械血栓清除术16例患者的临床资料,术后出现肉眼血红蛋白尿的患者为A组(n=9),余未出现血红蛋白尿的患者为B组(n=7),比较两组患者手术操作方式、术中抽吸时间、血栓负荷量的差异。结果 16例研究对象中9例出现血红蛋白尿,发生率为56.25%(9/16)。A组与B组手术方式(χ~2=1.667,P=0.197)、术中抽吸时间[(320.11±108.80)s vs(265.29±31.46)s,t=0.741,P=0.457]、血栓负荷量(χ~2=0.442,P=0.506)差异均无统计学意义。所有病例均无肾功能损害出现。结论 AngioJet机械血栓清除术后出现血红蛋白尿由多种因素所致,术中采用合理的抽吸方式、控制抽吸时间、围手术期积极对症处理,可降低血红蛋白尿的发生。

Objective To investigate the causes and factors of hemoglobinuria in patients with thrombosis after AngioJet mechanical thrombectomy. Methods The clinical data of 16 patients with thrombosis treated by AngioJet thrombectomy system were retrospectively analyzed. Nine patients with hemoglobinuria during the procedure were included in group A, while 7 patients without hemoglobinuria in group B. The type of surgical procedure, time of intraoperative aspiration and the thrombus volume were compared between both groups. Results Nine （9/16, 56.23%） of 16 patients were found hemoglobinuria during and after AngioJet mechanical thrombectomy. There were no statistically significant differences in surgical approaches （χ^2=1.667, P=0.197）, the time of intraoperative aspiration （[320.11±108.80]s vs [265.29±31.46]s, t=0.741, P=0.457）, the thrombus volume （χ^2=0.442, P=0.506） between both groups. No renal function failure were noted directly relating to the use of the AngioJet thrombectomy device. Conclusion There are many factors influenced the occurrence of hemoglobinuria in the patients after AngioJet thrombectomy. It can be reduced by using reasonable type of intraoperative aspiration, controled time of aspiration and active perioperative symptomatic treatment.