AngioJet吸栓治疗下肢深静脉血栓形成的疗效分析

Efficacy Analysis of AngioJet Thrombectomy in the Treatment of Deep Venous Thrombosis of Lower Extremity

目的比较AngioJet机械吸栓联合大腔导管和导管接触溶栓(catheter-directed thrombolysis,CDT)治疗髂静脉压迫综合征合并深静脉血栓形成的临床效果。方法回顾性分析2017年12月—2020年3月所有接受溶栓治疗的髂静脉压迫综合征合并深静脉血栓形成患者。34例采取AngioJet机械吸栓联合大腔导管吸栓+同期支架治疗的患者分为经皮机械性血栓清除术(percutaneous mechanical thrombectomy,PMT)组,30例采取CDT+分期支架治疗的患者分为CDT组,比较两组的手术和疗效指标。所有患者都接受了至少一年的随访。结果PMT组尿激酶用量(26.88±10.78)万U,平均住院时间(3.90±1.10)d;CDT组尿激酶用量(74.56±33.18)万U,平均住院时间(8.87±3.42)d,差异有统计学意义(P<0.05)。两组在术后下肢深静脉通畅率、并发症发生率、12个月随访Villata评分等指标的差异无统计学意义(P>0.05)。结论AngioJet机械吸栓联合大腔导管在一站式处理髂静脉病变、减少了患者住院时间及降低了溶栓风险和溶栓药物用量等方面更有优势,值得临床推广应用。

Objective To compare the clinical effects of AngioJet mechanical embolic aspiration combined with large lumen catheter and CDT in the treatment of iliac vein compression syndrome complicated with deep vein thrombosis.Methods Retrospective analysis was performed on all iliac vein compression syndrome patients with deep vein thrombosis who received thrombolytic therapy between December 2017 and March 2020.34 patients treated with AngioJet mechanical thrombectomy combined with large lumen catheter thrombectomy combined with concurrent stent were divided into PMT group,and 30 patients treated with CDT combined with staging stent were divided into CDT group.The surgery and efficacy indexes of the two groups were compared.All patients were followed up for at least one year.Results In PMT group,the amount of urokinase was(26.88±10.78)×10^(4)U,and the average length of hospital stay was(3.90±1.10)d.The amount of urokinase in CDT group was(74.56±33.18)×10^(4) U,and the average length of hospital stay was(8.87±3.42)d,with statistical significance(P<0.05).There were no statistically significant differences in the patency rate of lower extremity deep vein after operation,complication rate,Villata score at 12 months follow-up between the two groups(P>0.05).Conclusion AngioJet mechanical thrombus aspiration combined with large lumen catheter has more advantages in one-stop treatment of iliac vein disease,reducing hospitalization time,thrombolytic risk and dosage of thrombolytic drugs,which is worthy of clinical application.