AngioJet机械血栓清除术对急性髂股静脉血栓患者肾功能的影响

Effect of AngioJet thrombectomy on renal function in patients with acute iliofemoral deep venous thrombosis

目的探讨AngioJet机械血栓清除术对急性髂股静脉血栓患者肾功能的影响。方法收集2015年6月至2018年8月广州医科大学附属第二医院血管外科行AngioJet机械血栓清除术和导管溶栓治疗(CDT)的116例急性髂股静脉血栓患者的临床资料。整理分析患者术后3 d内的相关临床指标。通过单变量回归分析AngioJet机械血栓清除术与急性髂股静脉血栓患者术后肾损伤(AKI)的关系。结果行AngioJet机械血栓清除术的患者48例,行CDT的患者50例。两组患者在年龄、组间性别、是否患糖尿病、术前静脉溶栓、血肌酐值以及红细胞比容(HCT)方面比较差异均无统计学意义(P>0.05)。开放手术和HCT降低>10%能增加AngioJet机械血栓清除术后患者发生AKI的概率。单因素回归分析显示,AngioJet机械血栓清除术(OR=4.735,P=0.011)、传统开放手术(OR=12.391,P<0.001)以及HCT下降>10%(OR=29.857,P<0.001)均为急性髂股静脉血栓患者术后发生AKI的独立危险因素。结论AngioJet机械血栓清除术是AKI的独立风险因素,同时进行开放性手术和HCT下降>10%会增加AKI发生的概率。

Objective Investigate the effect of AngioJet thrombectomy on renal function in patients with acute iliofemoral deep venous thrombosis(DVT).Methods The data of patients with acute iliofemoral deep venous thrombosis who underwent AngioJet thrombectomy or catheter-directed thrombolysis(CDT)in our hospital from June 2015 to August 2018 were collected.Relevant clinical data within three days after operation were sorted out and the patients with acute kidney injury(AKI)were counted.The relationship between AngioJet thrombectomy and AKI in patients with acute iliofemoral DVT was analyzed by univariate regression analysis.Results There were 48 AngioJet thrombectomy patients and 50 CDT patients.There were no significant differences in average age,sex,diabetes mellitus,preoperative intravenous thrombolysis,serum creatinine and hematocrit(HCT)between both groups(P>0.05).Conventional open surgery and reduction in HCT>10%could increase the incidence of AKI in patients after AngioJet thrombectomy treatment.Univariate regression analysis showed that AngioJet thrombectomy(OR=4.735,P=0.011),conventional open surgery(OR=12.391,P<0.001)and reduction in HCT>10%(OR=29.857,P<0.001)were independent risk factors for AKI after operation in patients with acute iliofemoral DVT.Conclusion AngioJet thrombectomy is an independent risk factor for AKI,and conventional traditional open surgery and reduction in HCT>10%can also increase the incidence of AKI.