急性下肢缺血的外科治疗(附35例病例分析)  

Surgical treatment of acute loucer extremity ischemia (attached 35 cases)

作　　者：史伟浩[1] 余波[1] 王铁平[1] 

机构地区：[1]复旦大学华山医院外科,上海200040

出　　处：《中国现代医学杂志》2005年第4期555-557,共3页China Journal of Modern Medicine

摘　　要：目的探讨急性下肢缺血的外科治疗方法。方法回顾性分析该院2003年以来收治的35例急性下肢缺血患者的临床资料。结果35例患者中存活32例,所有患者术前存在下肢急性缺血的症状如患肢的疼痛、麻木、苍白或青紫、皮温降低、活动障碍均消失,或有不同程度的改善,27例患者术后可扪及足背及胫后动脉搏动。5例行截肢术。35例患者中3例死亡。动脉损伤1例。股部切口淋巴漏1例。随访2个月到1年。没有截肢的27例患者均恢复正常的日常生活。5例截肢患者患肢的缺血症状有不同程度的改善。结论要提高急性下肢缺血性疾病的治疗水平及改善预后,首先要加强对急性下肢缺血性疾病的认识,减少早期漏诊、误诊。其次尽快抗凝,溶栓,取栓或进行血管重建,缩短缺血时间。注意由于缺血造成的并发症的防治。To discuss the surgical treatment of acute lower extremity ischemia. We analyze 35 patients with acute lower extremity ischemia in our department from 2003. In these patients 32 patients survived, the symptom of acute lower extremity ischemia before operation such as pain, paralysis, pale, diable disappeared or improved after operation. The pulsation of dorsal pedal artery and post tibial artery can be touched in 27 patients. 5 patients accepted amputation, 3 patients died. 1 patients got artery trauma, 1 patients got lymphatic fistula. All these patients we followed up 2 months to 1 year. 27 patients without amputation all regain normal daily life, the symtom of ischemia in 5 patients with ampution got improved. [Conclusion] In order to elevate the level of the surgical treatment and to improve the progonosis of acute lower extremity ischemia, we must elevate the recogoniztion of the disease of acute lower extremity ischemia, and lower the misdiagnosis and missed diagnosis, begin the treatment of anticoagulation, thrombolysis, embolectomy and reconstruction of vessel as quick as possible. At the same time we must particularly pay attention to the prevention of the complication of acute lower extremity ischemia.

关 键 词：下肢动脉血栓形成 下肢动脉栓塞 取栓术 

分 类 号：R543.5[医药卫生—心血管疾病]