| 摘要: |
| ［摘要］ 目的 比较AngioJet机械性吸栓术与单纯导管碎栓联合溶栓术治疗中高危急性肺动脉栓塞（APE）的临床疗效。方法 选择2019年1月至2022年6月广西医科大学第四附属医院收治的中高危APE患者36例。根据患者的治疗意愿分为吸栓组（12例，采用AngioJet机械性吸栓治疗）和溶栓组（24例，采用单纯导管碎栓联合溶栓治疗）。比较两组的技术成功率、治疗成功率、手术操作时间、尿激酶用量、不良事件发生率、肺动脉栓塞（PE）复发率。结果 与溶栓组相比，吸栓组手术操作时间更长，尿激酶用量更少，手术前后经皮动脉血氧饱和度（SpO2）差更大，差异均有统计学意义（P<0.05）。两组技术成功率、治疗成功率比较差异无统计学意义（91.67% vs 95.83%，75.00% vs 79.17%；P>0.05）。两组肺血管损伤、肾功能损伤、心律失常发生率比较差异均无统计学意义（P>0.05）。吸栓组无出血病例，溶栓组发生出血8例（33.33%），两组出血率比较差异有统计学意义（P<0.05）。经3～24（12.50±3.25）个月随访，两组PE复发率比较差异无统计学意义（16.67% vs 12.50%；P>0.05）。结论 AngioJet机械性吸栓与单纯导管碎栓联合溶栓术均是治疗中高危APE的有效微创疗法。对于存在出血倾向的患者，AngioJet机械性吸栓在安全性上更具优势。 |
| 关键词: 急性肺栓塞 机械性吸栓 置管溶栓 |
| DOI：10.3969/j.issn.1674-3806.2022.12.15 |
| 分类号:R 563.5 |
| 基金项目:柳州市科技计划项目（编号：2019BJ10606） |
|
| Comparison of the efficacy of AngioJet mechanical thrombus aspiration and catheter thrombectomy combined with thrombolysis in treatment of intermediate/high-risk acute pulmonary embolism |
|
WEI Li-chun, SU Yi-ming, XU Tai-fu, et al.
|
|
Department of Vascular Surgery, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China
|
| Abstract: |
| ［Abstract］ Objective To compare the clinical efficacy of AngioJet mechanical thrombus aspiration and catheter thrombectomy combined with thrombolysis in treatment of intermediate/high-risk acute pulmonary embolism(APE). Methods Thirty-six patients with intermediate/high-risk APE who were admitted to the Fourth Affiliated Hospital of Guangxi Medical University from January 2019 to June 2022 were selected. The patients were divided into thrombus aspiration group(12 cases, treated with AngioJet mechanical thrombus aspiration) and thrombolysis group(24 cases, treated with catheter thrombectomy combined with thrombolysis) according to their treatment intentions. The technical success rate, treatment success rate, operation time, urokinase dosage, incidence of adverse events, and recurrence rate of pulmonary embolism(PE) were compared between the two groups. Results Compared with the thrombolysis group, the thrombus aspiration group had longer operation time, less amount of urokinase and greater difference in the percutaneous arterial oxygen saturation(SpO2) before and after operation, and the difference was statistically significant(P<0.05). There were no significant differences in the technical success rate and the treatment success rate between the two groups(91.67% vs 95.83%, 75.00% vs 79.17%; P>0.05). There were no significant differences in the incidence rates of pulmonary vascular injury, renal function injury and arrhythmia between the two groups(P>0.05). There was no bleeding in the thrombus aspiration group, while bleeding occurred in 8 cases(33.33%) in the thrombolysis group, and the difference in the bleeding rate between the two groups was statistically significant(P<0.05). After 3-24(12.50±3.25)months of follow-up, there was no significant difference in the recurrence rate of PE between the two groups(16.67% vs 12.50%; P>0.05). Conclusion Both AngioJet mechanical thrombus aspiration and catheter thrombectomy combined with thrombolysis are effective and minimally invasive therapies for treatment of intermediate/high-risk APE. For patients with bleeding tendency, AngioJet mechanical thrombus aspiration has more advantages in safety. |
| Key words: Acute pulmonary embolism(APE) Mechanical thrombus aspiration Catheter thrombolysis |
