超声引导下穿刺抽吸血肿加人工压迫治疗医源性股动脉假性动脉瘤

发布时间：2018-11-26 18:16

【摘要】：目的:探讨超声引导下穿刺抽吸血肿加人工压迫法治疗心脏介入术后股动脉假性动脉瘤的安全性和有效性。方法:分析27例心脏介入操作术后出现的股动脉假性动脉瘤患者,其中男性14例,女性13例,平均年龄(53.5±11.4)岁。首先利用超声定位股动脉假性动脉瘤体、瘤体颈部和供应动脉位置,然后在超声引导下采用18号穿刺针,穿刺进入瘤体中心并且抽吸瘤体内血液,同时由助手采用人工方法压迫股动脉假性动脉瘤颈部和瘤体,阻断供应动脉和股动脉假性动脉瘤之间的交通。压迫时间为15 min,之后用绷带加压包扎,嘱患者平卧12 h,保持患侧下肢平直。术后24 h和1个月均复查下肢血管超声。结果:24例(88.9%)患者一次抽吸压迫成功;2例(7.4%)患者第一次抽吸压迫后瘤体未完全闭塞,给予再次抽吸压迫后成功;1例(3.7%)患者因合并股动静脉瘘,抽吸压迫后股动脉假性动脉瘤腔未完全闭合,但瘤体较压迫前明显缩小。总体治疗成功率为96.3%(26/27例)。无操作相关并发症发生。结论:在超声引导下穿刺抽吸血肿加人工压迫治疗医源性股动脉假性动脉瘤安全、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 卤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.
【作者单位】：中国医学科学院北京协和医学院国家心血管病中心阜外医院心律失常诊治中心;
【分类号】：R445.1;R543.5

【相似文献】