腹主动脉栓塞的外科治疗及围手术期处理  

Surgical and perioperative treatments for the embolism of the abdominal aorta

作　　者：李学锋[1] 董宗俊[1] 张建[1] 俞恒锡[1] 谷涌泉[1] 李建新[1] 汪忠镐[1] 

机构地区：[1]首都医科大学血管外科研究所,宣武医院血管外科,北京100053

出　　处：《临床外科杂志》2006年第5期281-282,共2页Journal of Clinical Surgery

摘　　要：目的提高腹主动脉栓塞治疗水平。方法对26例腹主动脉栓塞患者采用经双股动脉Fogarty导管取栓15例,经腹取栓11例。结果26例患者手术后死亡8例,手术死亡率30.8%。其中经双股动脉取栓者死亡3例,死亡率20%,经腹取栓者死亡5例,死亡率45.5%。术后3例共3条肢体因缺血坏死行截肢术。经平均12.7年随访,除4例死于原发之心脏病外,余14例27条肢体无严重血液循环障碍。结论采用经双股动脉Fogarty导管取栓术及合理的围术期处理可明显降低手术死亡率。而针对病因的积极治疗可提高远期生存率。Objective To study retrospectively the experience of the diagnosis and treatment of 26 patients and summarize the effective methods for the embolism of the abdominal aorta. Methods Transfemoral embolectomy was performed in 15 patients and transaortic embolectomy in 11 patients. Results Of the 26 patients, 8 died after operation（operative mortality was 30.8 % ）. The mortality of transfemoral embolectomy was 20 % and that of transaortic emboiectomy was 45.5 % respectively. Three amputations were performed due to limbs＇ ischemia and necrosis. During an average followup period of 12.7 years, 4 patients died of primary heart disease and the others with 27 limbs had no serious ischemia. Conclusion It is necessary for different patients to apply different operative approaches. Prompt and accurate diagnosis, proper transfemoral embolectomy with Fogarty Catheter and rational perioperative treatments can decrease the operative mortality. Treatment to etiologic factor can increase the long-term survival rate.

关 键 词：栓塞 腹主动脉 经双股动脉取栓术 经腹取栓术 

分 类 号：R654.3[医药卫生—外科学]