急性肢体动脉栓塞的综合介入治疗效果分析  

Curative effect of combined interventional therapy for acute limb arterial embolism

作　　者：马坤[1] 顾建平[1] 楼文胜[1] 何旭[1] 陈亮[1] 陈国平[1] 苏浩波[1] 宋进华[1] 汪涛[1] 

机构地区：[1]南京医科大学附属南京第一医院介入科,江苏南京210006

出　　处：《中国医学影像技术》2009年第11期2118-2121,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家科技部"十一五"支撑计划课题项目(2007BAI05B04)

摘　　要：目的探讨介入综合治疗对急性肢体动脉栓塞的疗效。方法对38例急性肢体动脉栓塞患者(43条患肢)采用经皮导管球囊动脉成形术或支架植入术进行介入治疗,术后除1例转外科行Fogarty导管取栓术外,其余病例均予持续导管接触性溶栓及抗凝、扩血管、祛聚、改善微循环等辅助治疗。结果介入治疗技术成功率100%;37条(86.05%)患肢治疗有效,其中痊愈29条(67.44%),7条(16.28%)疗效良好,1条(2.33%)疗效一般;4条(9.30%)患肢截趾或低位截肢;2例患者死亡(5.26%)。随访1～32个月,3例患者3个月内再发肢体动脉栓塞,再行介入治疗后痊愈出院,其余病例均未再发栓塞。结论综合介入治疗可明显改善急性肢体动脉栓塞患者的致残率和致死率,有效降低再栓塞风险。Objective To investigate the efficacy of combined interventional therapy for acute limb arterial embolism.Methods Thirty-eight patients（43 limbs）with acute limb arterial embolism were treated with interventional therapies.After percutaneous transcatheter endovascular treatment including balloon angioplasty and stent placement,one patient received embolectomy with Fogarty catheter,the others accepted continuous catheter-directed thrombolysis and adjunctive pharmacotherapy with agents of anticoagulation,vasodilation and antiplatelet to improve microcirculation.Results The technical success rate of endovascular procedures was 100% in this group.Thirty-seven（86.05%）affected limbs were cured effectively,including 29（67.44%）excellent,7（16.28%）good and 1（2.33%）fair.Toe or lower limb amputation were performed in 4 affected limbs（9.30%）,whereas 2 patients died（5.26%）.During 1—32 months follow-up,limb arterial embolism occurred in 3 patients within 3 months,who the patients underwent interventional therapy again and obtained recovery,and no recurrent embolism was found in the other patients.Conclusion Combined interventional therapy can significantly decrease the disability and mortality rates,and effectively reduce the risk of re-embolism in patients suffered from acute limb arterial embolism.

关 键 词：动脉栓塞 介入性 溶栓治疗 

分 类 号：R73-37[医药卫生—肿瘤] R817.4[医药卫生—临床医学]