| 摘要: |
| ［摘要］ 目的 探讨AngioJet机械性血栓抽吸术治疗中高危急性肺动脉栓塞（APE）的疗效和安全性。方法 选择2020年1月至2021年3月广西医科大学第四附属医院收治的18例中高危APE患者的临床资料，均接受AngioJet机械性血栓抽吸术。分析患者术中并发症发生情况、术后临床疗效，以及手术前后呼吸、心率、经皮血氧饱和度（TCSO2）、肺动脉平均压、血清肌酐等临床指标的变化情况。结果 手术成功率为100.0%，临床症状明显改善率为83.3%（15/18），临床救治成功率为94.4%（17/18）,术后死亡1例。术后造影显示：7例栓塞段肺动脉完全复通，10例部分复通，1例未复通。术中发生心律失常2例，未见肺动脉夹层、破裂等肺血管损伤发生。术中出血发生率为27.8%（5/18），均为轻微出血。17例成功救治患者的呼吸、心率和肺动脉平均压水平均较术前降低，TCSO2较术前升高，差异有统计学意义（P<0.05）。治疗前后血清肌酐水平变化不显著（P>0.05）。结论 AngioJet机械性血栓抽吸术治疗中高危APE安全、有效。规范、轻柔操作并快速抽吸血栓，有助于进一步提高手术安全性，改善患者预后。 |
| 关键词: 急性肺动脉栓塞 AngioJet 机械性血栓抽吸 疗效 安全性 |
| DOI：10.3969/j.issn.1674-3806.2022.02.15 |
| 分类号:R 605 |
| 基金项目:柳州市科技计划项目（编号：2019BJ10606） |
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| Application of AngioJet mechanical thrombus aspiration in treatment of middle/high-risk acute pulmonary embolism |
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WEI Li-chun, SU Yi-ming, XU Tai-fu, et al.
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Department of Vascular Surgery, the Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China
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| Abstract: |
| ［Abstract］ Objective To investigate the efficacy and safety of AngioJet mechanical thrombus aspiration in treatment of middle/high-risk acute pulmonary embolism(APE). Methods The clinical data of 18 middle/high-risk APE patients admitted to the Fourth Affiliated Hospital of Guangxi Medical University from January 2020 to March 2021 were selected. All the patients underwent AngioJet mechanical thrombus aspiration. The incidence of the patients′ intraoperative complications, postoperative clinical efficacy, and the changes in clinical indicators such as respiration, heart rate, transcutaneous oxygen saturation(TCSO2), mean pulmonary artery pressure, and serum creatinine before and after surgery were analyzed. Results The patients′ surgical success rate was 100.0%, and the clinical symptom improvement rate was 83.3%(15/18). The success rate of clinical treatment was 94.4%(17/18), and one case died after operation. The results of postoperative angiography showed complete recanalization of the embolic pulmonary artery in 7 cases, partial recanalization in 10 cases, and no recanalization in 1 case. Two cases of arrhythmia occurred during the operation. No pulmonary vascular injury such as pulmonary artery dissection and rupture occurred during the operation. The incidence of intraoperative bleeding was 27.8%(5/18), and minor bleeding occurred in all the cases of intraoperative bleeding. Compared with those before operation, the respiration, heart rate and mean pulmonary artery pressure of the 17 patients who were successfully treated were decreased, and the TCSO2 was increased after operation, and the differences were statistically significant(P<0.05). Compared with those before treatment, serum creatinine levels did not change significantly after treatment(P>0.05). Conclusion AngioJet mechanical thrombus aspiration is safe and effective in treatment of middle/high-risk APE. Standardized, gentle operation and rapid aspiration of thrombus are helpful to further improve the surgical safety and improve the prognosis of the patients. |
| Key words: Acute pulmonary embolism(APE) AngioJet Mechanical thrombus aspiration Efficacy Safety |
