Angiojet机械吸栓治疗在手术相关下肢深静脉血栓患者中的应用及疗效

Application of Angiojet mechanical thrombectomy in patients with postoperative deep venous thrombosis and its efficacy

目的:评价Angiojet机械吸栓治疗手术相关下肢深静脉血栓形成(DVT)患者的早期疗效和安全性。方法:回顾性分析2015年9月—2017年1月91例急性DVT(中央或者混合型)患者临床资料,其中30例为手术相关DVT(观察组),61例为非手术相关DVT(对照组),两组患者均首选Angiojet吸栓治疗,后续辅以导管接触性溶栓(CDT)或支架植入,比较两组患者相关临床指标。结果:两组患者术前一般资料无统计学差异(均P>0.05)。两组患者支架植入率、支架直径和长度差异均无统计学意义(均P>0.05),对照组平均溶栓时间明显长于观察组(2.31 d vs. 1.50 d,P<0.05)。两组均无大出血事件及死亡、心血管事件等严重并发症发生,对照组和观察组分别出现6例和4例穿刺点出血,及新发2例及1例症状性肺动脉栓塞,差异均无统计学意义(均P>0.05)。两组术后1年通畅率(对照组:88.52% vs.观察组:90.00%)、VRI评分及Villalta评分差异均无统计学意义(均P>0.05)。结论: Angiojet吸栓治疗用于手术相关DVT安全且有效。

Objective: To evaluate the early efficacy and safety of Angiojet mechanical thrombectomy in treatment of patients with postoperative deep venous thrombosis (DVT). Methods: The clinical data of 91 patients with acute DVT (central or mixed type) treated from September 2015 to January 2017 were retrospectively analyzed. Of the patients, 30 cases had postoperative DVT (observation group) and 61 cases had non-postoperative DVT (control group). The relevant clinical variables between the two groups were compared. Results: There were no significant differences in terms of preoperative data between the two groups of patients (all P>0.05). The stent implantation rate as well as the diameter and length of the stents showed no significant differences between the two groups (all P>0.05), but the average time for thrombolysis in control group was significantly longer than that in observation group (2.31 d vs.1.50 d, P<0.05). There were no serious complications such as major bleeding events and cardiovascular events or death occurred in either of the groups. Puncture site bleeding occurred in 6 cases and 4 cases and newly developed symptomatic pulmonary embolism occurred in 2 cases and 1 case in control group and observation group respectively, and the differences showed no statistical significance (both P>0.05). The 1-year patency rate (control group: 88.52% vs. observation group: 90.00%), VRI score and Villalta score showed no statistical difference between the two groups (all P>0.05). Conclusion: Using Angiojet mechanical thrombectomy in treatment of postoperative DVT is safe and effective.