超声引导下假性动脉瘤内注药封堵术的安全性和有效性研究

Safety and efficacy evaluation of ultrasound-guided thrombin injection into pseudoaneurysm

目的探讨超声引导下假性动脉瘤内注药封堵术的安全性和临床应用价值。方法回顾性分析354例行超声引导下凝血酶注射治疗的医源性假性动脉瘤患者的临床资料和超声特征,计算封堵治疗的成功率,分析假性动脉瘤大小与凝血酶使用剂量之间的关系。结果假性动脉瘤直径4.8~140.0 mm,平均(28.1±13.3)mm。入囊最大流速21~720 cm/s,平均(234.2±112.5)cm/s,出囊最大流速10~549 cm/s,平均(117.7±71.4)cm/s。第一次封堵即治疗成功者329例,治疗成功率92.9%。单纯性假性动脉瘤与复杂性假性动脉瘤治疗成功率比较差异无统计学意义(93.4%vs. 91.0%)。假性动脉瘤大小与凝血酶使用剂量之间存在等级相关性(rs=0.14,P=0.01)。结论超声引导下假性动脉瘤内注药封堵术是一种安全有效的治疗方法,有较高的临床应用价值。

Objective To investigate the safety and clinical application value of ultrasound-guided thrombin injection into pseudoaneurysm.Methods The clinical data and ultrasonographic characteristics of 354 patients with iatrogenic pseudoaneurysm treated by ultrasound-guided thrombin injection were analyzed retrospectively,the success rate of treatment was calculated,and the relationship between the size of pseudoaneurysm and the dosage of thrombin was analyzed.Results The diameter of pseudoaneurysm was 4.8~140.0 mm,with an average of(28.1±13.3)mm. The maximum inflow velocity was 21~720 cm/s,with an average maximum inflow velocity of(234.2 ±112.5)cm/s,and the maximum outflow velocity was 10 ~549 cm/s,with an average outflow velocity of(117.7 ±71.4)cm/s. 92.9% of patients were successfully treated during the initial thrombin injection,the success rate was 92.9%.There was no significant difference in the success rate between simple pseudoaneurysm and complex pseudoaneurysm(93.4% vs. 91.0%).There was a certain correlation between the size of pseudoaneurysm and the dose of thrombin(rs=0.14,P=0.01). Conclusion Ultrasound-guided thrombin injection into pseudoaneurysm is a safe and highly effective method,which has high clinical application value.