彩色多普勒血流显像引导近瘤颈部收缩期分次注射小剂量凝血酶溶液治疗股动脉假性动脉瘤效果.docVIP

彩色多普勒血流显像引导近瘤颈部收缩期分次注射小剂量凝血酶溶液治疗股动脉假性动脉瘤效果 　　[摘要] 目的 探?彩色多普勒血流显像（CDFI）引导近瘤颈部收缩期分次注射小剂量凝血酶溶液治疗股动脉假性动脉瘤（PSA）临床疗效和安全性。 方法 回顾性研究2012年1月～2013年12月CDFI引导凝血酶注射治疗股动脉PSA患者18例，共18个瘤腔，平均最大径（3.2±1.0）cm（1.3～5.7 cm）。两位操作者配合，CDFI引导下将21G PTC针进针至近瘤颈部，收缩期分次注射凝血酶溶液（浓度250IU/mL），每次注射0.05或0.1mL。CDFI示瘤腔内无血流信号时结束治疗，必要时另行择点进针重复上述操作。术后评价疗效并密切观察并发症。 结果 一次治疗成功率为100.0%（18/18），平均注射凝血酶为（102.8±45.3）IU（25～200 IU）。术后即刻CDFI示瘤腔内血流信号消失率为100.0%（18/18），1例（5.6%）仅瘤颈部仍可见血流信号的患者，经加压包扎后第2日复查时瘤腔内及瘤颈部均未显示血流信号。术中、术后即刻和随访期内均未出现治疗相关的远端动脉栓塞征象和过敏反应，术后瘤腔局部无复发。 结论 CDFI引导近瘤颈收缩期分次注射小剂量凝血酶溶液治疗股动脉PSA是一种安全有效的方法 [关键词] 股动脉假性动脉瘤；超声；彩色多普勒血流显像；凝血酶；介入治疗 [中图分类号] R445.1 [文献标识码] A [文章编号] 1673-7210（2017）02（a）-0082-04 Clinical outcomes of femoral pseudoaneurysm using fractionated small dose thrombin injection adjacent to the neck during systoleguided by color Doppler flow imaging CHENG Zhigang HAN Zhiyu LIU Fangyi YU Jie CHEN Hongfeng Interventional Ultrasound Department of Chinese PLA General Hospital， Beijing 100853， China [Abstract] Objective To evaluate the safety and efficacyon treatments of femoral pseudoaneurysms （PSAs） using fractionated small dose thrombin injection adjacent to the neck during systole guided by color Doppler flow imaging （CDFI）. Methods From January 2012 to December 2013， the clinical data of 18 patients with 18 femoral PSAs were retrospectively analyzed， who accepted the procedure of fractionated small dose thrombin injection. The mean maximal diameter of the PSAs was （3.2±1.0） cm （range from 1.3 cm to 5.7cm）. Under the cooperation of two operators， a twenty-one gauge PTC needle advanced into the sac adjacent to the neck and thrombin solution with the concentration of 250 international unit （IU） per milliliter （ml） was injected during systole by real-time observation of CDFI with the dose of 0.5 or 1.0 mL per injection. The procedure was completed when no blood flow signal was shown in the sac on CDFI. If necessary， the above procedure was repeated via another approach. Curative effects was