超声引导下注射凝血酶对假性动脉瘤的治疗

Treatment of pseudoaneurysm with thrombin injection under ultrasound guidance

目的探讨超声实时引导下凝血酶注射对医源性假性动脉瘤的治疗价值。方法收集津南区咸水沽医院2014-2016年期间经皮股动脉穿刺进行冠脉介入治疗后发生股动脉假性动脉瘤的12例患者,行超声引导下瘤腔内注射凝血酶(浓度为100 U/ml),直至瘤腔内充满血栓,血流消失。分析假性动脉瘤瘤体的大小、颈部长宽、凝血酶用量及疗效,观察其并发症。结果 12例股动脉假性动脉瘤均位于右侧腹股沟区,瘤体平均大小为(4.5×2.8×2.5)cm3,瘤颈宽度为(2.5±1.0)mm,瘤颈长度为(5.2±0.7)mm,平均凝血酶用量为(150±70)U。12例均未出现感染、血栓、栓塞、出血、过敏反应等并发症。随访无1例复发。结论超声实时引导下瘤腔内注射凝血酶治疗医源性股动脉假性动脉瘤,患者痛苦小,安全有效,可做为医源性股动脉假性动脉瘤的首选治疗方法。

Objective To evaluate the clinical significance of thrombin injection under ultrasound guidance for iatrogenic pseudoaneurysm patients.Methods 12 patients with femoral artery pseudoaneurysm after percutaneous coronary intervention were collected from Jinnan District Xianshuigu Hospital from 2014 to2016.The thrombin（100 U/ml） was injected into the tumor under ultrasound guidancec until the tumor cavity was filled with thrombosis and blood flow disappeared.The size,neck width and length of pseudoa-neurysm,the dosage of thrombin and the curative effect were analyzed.The complication was observed.Results All the 12 femoral artery pseudoaneurysm were located in the right groin.The average size of the tumor was（4.2×2.8×2.5）cm3.The tumor neck widthes were about（2.5±1.0） mm,the length were（5.2±0.7） mm,the average dosage of thrombin were（150±70） U.None of the 12 patients had complications such as infection,thrombosis,embolism,bleeding or allergic reaction.No recurrence was found during follow-up.Conclusion Ultrasound-guided injection of thrombin in the treatment of iatrogenic femoral artery pseudoaneurysm is with small pain in patients,safe and effective.This method can become the first choice for the clinical treatment of iatrogenic pseudoaneurysm.