急性肾下腹主动脉骑跨栓塞的临床治疗体会  

The treatment of acute infrarenal abdominal overriding aorta occlusion

作　　者：董健[1] 李玉涛[1] 姜同柏[1] 

机构地区：[1]临沂市人民医院血管外科,山东临沂276003

出　　处：《黑龙江医药科学》2005年第5期41-42,共2页Heilongjiang Medicine and Pharmacy

摘　　要：目的:总结肾下腹主动脉骑跨栓塞的救治经验和教训。方法:回顾性分析了4年间我院采用双侧股动脉Fogarty导管取栓治疗腹主动脉骑跨栓塞15例,导管碎栓联合置管微量泵药物溶栓4例。结果:血流再通后早发死亡2例,主要原因为高血钾引起的心跳骤停;迟发死亡2例,术后肌病肾病代谢综合征是死亡的主要原因;存活15例,有3例截去单侧或双侧下肢;远期随访11例,存活肢体血运良好。结论:早期诊断,早期取栓或早期血管腔内置管溶栓治疗是降低腹主动脉骑跨栓塞病死率和截肢率的关键;肌病肾病代谢综合征是急性腹主动脉栓塞的常见、严重并发症,其有效防治是急性腹主动脉栓塞治疗成功与否的关键因素之一,应引起足够的重视。Objective： To sum up the experience in the management of acute infrarenal abdominal overriding aorta occlusion. Methods： Fifteen cases of abdominal overriding aorta embolism were treated with Forgarty catheter, and 4 cases were treated with thrombolytic therapy through arterial intubation combined with vascular pump. Results： After the blood perfusion recovered, 2 died in the early stage because of cardiac arrest due to hyperkalemia and 2 died in the late stage, acute post-operative renal failure metabolic acidosis and hyperkalemie being the main cause of death. In 15 cases alive, 3 received amputation and 11 cases were followed up and the blood supply of the legs alive was fine. Conclusion： Early diagnosis and treatment are key points to decrease the rate of death and amputation Myonephropathic metablic syndrome （MNMS）,a common and severe complication of AAO, would have a great impact on the therapeutic outcome .

关 键 词：腹主动脉 栓塞 肌病肾病代谢综合征 血管外科手术 置管溶栓 

分 类 号：R692.39[医药卫生—泌尿科学]