HCDU引导下Fogarty导管取栓术与切开探查术在链式静脉血管栓塞中应用的比较研究

A COMPARATIVE STUDY ON APPLICATION OF FOGARTY CATHETER THROMBECTOMY UNDER GUIDANCE OF HCDU AND EXPLORATORY INCISION IN CHAIN VENOUS EMBOLIZATION

目的 比较高频彩色多普勒超声(High Frequency Color Doppler Ultrasound,HCDU)引导下Fogarty导管取栓术、切开探查术在链式静脉血管栓塞中应用的疗效。方法 回顾性研究2010年2月—2021年4月,该院收治的75例在断肢再植术后出现链式静脉血管危象,经HCDU诊断为血管栓塞,依据手术方式分为微创介入组(即HCDU引导下Fogarty导管取栓术,35例),开放处理组(即切开探查术,40例),对二组术前一般情况,手术、随访相关评价指标予以对比研究。结果 手术前一般情况的各项临床指标二组比较差异均无统计学意义(P>0.05),可进行比较研究;术中血管通畅率二组比较差异无统计学意义(P>0.05),血管再灌注时间、总手术时间及总出血量,微创介入组少(低)于开放处理组(P<0.05)。术后浅表组织感染率、再次栓塞率、截肢率,微创介入组低于开放处理组(P<0.05);术后8个月随访患肢功能优良率二组比较差异无统计学意义(P>0.05);住院医疗费微创介入组高于开放处理组(P<0.05)。结论 HCDU引导下Fogarty导管取栓术式应用在链式静脉血管栓塞的病例中,血栓定位精准,术中处理微创,术式操作快捷,早、中期效果确定,但会增加患者医疗费用。

Objective To compare the efficacy Fogarty catheter thrombectomy guided by High Frequency Color Doppler Ultrasound(HCDU) and incision exploration in chain vein embolization.Methods From February 2010 to April 2021,a retrospective study showed that seventy five cases of chain venous vascular crisis occurred in this hospital after replantation of severed limbs, a vascular embolism was diagnosed by HCDU,according to surgical method divided into minimally invasive intervention group(Fogarty catheter thrombectomy under the guidance of HCDU,35 cases),and open treatment group(exploratory incision, 40 cases),the preoperative general condition, operation and follow-up related evaluation indicators were compared between the two groups.Results There were no significant differences in the clinical indicators of general conditions before surgery between the two groups(P>0.05),and a comparative study was possible;there was no significantdifference in the intraoperative vascular patency rate between the two groups(P>0.05).The time, total operation time and total blood loss were less(lower) in the minimally invasive intervention group than in the open treatment group(P<0.05).The postoperative superficial tissue infection rate, re-embolization rate, and amputation rate were lower in the minimally invasive intervention group than in the open treatment group(P<0.05);inpatient medical expenses in the minimally invasive intervention group were higher than those in the open treatment group(P<0.05).Conclusion Fogarty catheter thrombectomy under the guidance of HCDU is applied in the cases of chain venous embolism.The thrombus is positioned accurately, the intraoperative treatment is minimally invasive, the surgical operation is fast, and the early and mid-term effects are certain, but it will increase the medical expenses of patients.