AngioJet血栓抽吸装置联合CDT对急性下肢动脉缺血的疗效研究

摘要

Objective To compare the efficacy of AngioJet thrombus aspiration device combined with catheter contact thrombolysis (CDT) with traditional CDT in acute lower extremity arterial ischemia, in order to find a more suitable treatment. Methods 86 patients with acute lower extremity arterial ischemia admitted to the Department of General Surgery (Vascular Surgery), Cangzhou People's Hospital from January 2017 to January 2018 were randomly divided into AngioJet thrombus aspiration device + CDT group (joint group, n=46) and the traditional CDT group (traditional group, n=40). Biochemical indicators such as hemoglobin, alanine aminotransferase, aspartate aminotransferase, urease and creatinine were routinely detected after surgery. Patient tolerance and thrombus clearance and patency rates were recorded and compared. Results There were no significant differences in the age, BMI and sex ratio between the two groups (P>0.05). The hospitalization time of the combined group was shorter than that of the traditional group, and the difference was statistically significant (P0.05). The urokinase levels in the combination group were significantly higher than those in the conventional group. There were fewer groups and the difference was statistically significant (P<0.05). The thrombus clearance rate of the combined group was significantly better than that of the traditional group, and the difference was statistically significant (P<0.05). The tolerance scores of the two groups were better than the traditional group, and the difference was statistically significant (P<0.05). Conclusion AngioJet thrombotic suction device combined with appropriate CDT can rapidly remove thrombosis, restore blood supply, reduce amputation rate and improve the quality of life of patients with acute lower extremity arterial ischemia, especially in patients with fresh thrombosis.%目的 对比分析急性下肢动脉缺血中AngioJet血栓抽吸装置联合导管接触性溶栓(CDT)与传统CDT的疗效,以期寻求更为适合的治疗方案.方法 选取沧州市人民医院普外血管外科2017年1月至2018年1月收治的86例急性下肢动脉缺血的患者为研究对象,采用随机数字表法分为AngioJet血栓抽吸装置联合CDT组(联合组,n=46)与传统CDT组(传统组,n=40).术后常规检测血红蛋白、丙氨酸氨基转移酶、天冬氨酸氨基转移酶、尿素酶和肌酐等生化指标.记录并对比患者耐受情况以及血栓清除率和通畅率.结果 两组患者的年龄、体质指数(BMI)和性别比例比较,差异均无统计学差异(P均＞0.05);联合组患者的住院时间比传统组短,差异具有统计学意义(P＜0.05).联合组和传统组的手术情况显示,两组血栓部位及病因和诱因比较,差异均无统计学意义(P均＞0.05);两组尿激酶用量的比较,联合组所用的尿激酶明显比传统组要少,差异具有统计学意义(P＜0.05).联合组的血栓清除率要明显优于传统组,差异具有统计学意义(P＜0.05);两组患者的耐受情况评分比较,联合组要优于传统组,差异具有统计学意义(P＜0.05).结论 AngioJet血栓抽吸装置联合CDT的方案在急性下肢动脉缺血中可迅速清除血栓、恢复血供,减少截肢率,提高患者生活质量.