Amplatz血栓消融器的临床应用

Clinical application of Amplatz thrombectomy device

目的 探讨Amplatz血栓消融器的临床应用价值。方法 对病程 1～ 14d(平均 6 2 5d)的 3 1例髂股静脉血栓、7例肺动脉栓塞、8例髂股动脉血栓用Amplatz血栓消融器 (ATD)进行治疗。评估ATD的即刻疗效 ,分为优、良、中、差 4级。结果 46例ATD消融术的即刻疗效 :优 :2 8 3 % ;良 :52 2 % ;中 :13 0 % ;差 :6 5%。优良率为 80 5% ;总有效率 (优 +良 +中 )为 93 5%。完成ATD操作后 ,3 1例髂股静脉血栓中 2 2例 (71 0 % )下肢肿痛减轻 ;7例肺动脉栓塞的缺氧症状均明显改善 ;8例髂股动脉血栓下肢疼痛明显减轻 ,踝臂指数从 0 58± 0 2 4上升至 0 89± 0 14。46例均未发生明显并发症。

Objective To determine the eff iciency and the benefits of the Amplatz thrombectomy device(ATD)in acute thromboembolic occlusions of iliofemoral arteries and veins and pulmonary embolism. Methods Forty-six cases(mean age 55.9 years) presenting with acute thromboembolic occlusions of the iliofemoral veins( n =31) and the pulmonary embolism( n =7) and the iliofemoral arteries( n =8) at 1 to 14 days (mean 6 25 days) underwent mechanical thrombolysis with ATD. The ATD treated blood vessels were graded on a scale of 1(excellent),2(good),3(mild), and 4(no changes). Results The percentage of instant efficiency in 46 cases included 28.3% of grade 1, 52.2% of grade 2, 13.0% of grade 3, and 6 5% of grade 4, respectively. The grade 1 plus grade 2 was 80.5% and the total efficiency (grade 1+2+3) was 93.5%. The swelling and pain of limb in 22 cases of 31 iliofemoral vein thrombosis got relieved after mechanical thrombectomy. The symptoms of hypoxia in 7 pulmonary embolisms were all improved. The pains of 8 iliofemoral artery thrombosis were obviously relieved, and the ankle-brachial-index increased from 0 58± 0.24 to 0.89±0.14. No significant complications occurred as a result of this procedure in 46 cases. Conclusion The ATD is an effective and safe procedure in the treatment for acute thromboembolic occlusions of iliofemoral arteries and veins and for pulmonary embolism.