【摘要】：目的:探討超聲引導(dǎo)下穿刺抽吸血腫加人工壓迫法治療心臟介入術(shù)后股動(dòng)脈假性動(dòng)脈瘤的安全性和有效性。方法:分析27例心臟介入操作術(shù)后出現(xiàn)的股動(dòng)脈假性動(dòng)脈瘤患者,其中男性14例,女性13例,平均年齡(53.5±11.4)歲。首先利用超聲定位股動(dòng)脈假性動(dòng)脈瘤體、瘤體頸部和供應(yīng)動(dòng)脈位置,然后在超聲引導(dǎo)下采用18號(hào)穿刺針,穿刺進(jìn)入瘤體中心并且抽吸瘤體內(nèi)血液,同時(shí)由助手采用人工方法壓迫股動(dòng)脈假性動(dòng)脈瘤頸部和瘤體,阻斷供應(yīng)動(dòng)脈和股動(dòng)脈假性動(dòng)脈瘤之間的交通。壓迫時(shí)間為15 min,之后用繃帶加壓包扎,囑患者平臥12 h,保持患側(cè)下肢平直。術(shù)后24 h和1個(gè)月均復(fù)查下肢血管超聲。結(jié)果:24例(88.9%)患者一次抽吸壓迫成功;2例(7.4%)患者第一次抽吸壓迫后瘤體未完全閉塞,給予再次抽吸壓迫后成功;1例(3.7%)患者因合并股動(dòng)靜脈瘺,抽吸壓迫后股動(dòng)脈假性動(dòng)脈瘤腔未完全閉合,但瘤體較壓迫前明顯縮小。總體治療成功率為96.3%(26/27例)。無(wú)操作相關(guān)并發(fā)癥發(fā)生。結(jié)論:在超聲引導(dǎo)下穿刺抽吸血腫加人工壓迫治療醫(yī)源性股動(dòng)脈假性動(dòng)脈瘤安全、有效。
[Abstract]:Objective: to evaluate the safety and efficacy of ultrasound guided aspiration of hematoma and artificial compression in the treatment of femoral artery pseudoaneurysm after cardiac intervention. Methods: Twenty-seven patients with femoral artery pseudoaneurysm after cardiac interventional operation were analyzed, including 14 males and 13 females, with an average age of (53.5 鹵11.4) years. The pseudo artery tumor, neck and supply artery of femoral artery were first located by ultrasound, and then the puncture needle 18 was used under the guidance of ultrasound to enter the center of the tumor and draw blood from the tumor. At the same time, the assistant used artificial method to compress the neck and tumor of femoral artery pseudoaneurysm to block the communication between supply artery and femoral artery pseudoaneurysm. After the compression time was 15 min, bandage was applied and the patient was told to lie down for 12 hours to keep the affected lower limbs straight. The lower extremity vascular ultrasound was reexamined 24 h and 1 month after operation. Results: 24 cases (88.9%) were successful in one aspiration and compression, 2 cases (7.4%) were not completely occluded after the first suction and compression. In one case (3.7%), the femoral artery pseudoaneurysm was not completely closed after aspiration and compression, but the tumor was smaller than that before compression. The overall success rate was 96.3% (26 / 27 cases). No operative-related complications occurred. Conclusion: it is safe and effective to treat iatrogenic femoral artery pseudoaneurysm with aspiration hematoma and artificial compression under the guidance of ultrasound.
【作者單位】： 中國(guó)醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)學(xué)院國(guó)家心血管病中心阜外醫(yī)院心律失常診治中心;
【分類號(hào)】：R445.1;R543.5

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