急诊腹主动脉骑跨栓塞26例诊治体会  

Treatment of Acute Abdominal Aorta Saddle Embolism:A Report of 26 Cases

作　　者：罗英伟[1] 韩雪[1] 杨德华[1] 张健[1] 辛世杰[1] 

机构地区：[1]中国医科大学附属第一医院血管外科,辽宁省沈阳市110001

出　　处：《中国全科医学》2010年第35期3994-3995,共2页Chinese General Practice

摘　　要：目的探讨腹主动脉骑跨栓塞的诊断和治疗方法。方法回顾性分析我院近10年来26例腹主动脉骑跨栓塞患者的临床资料。结果根据临床表现及彩色多普勒超声检查可早期诊断,CT血管造影可以确诊。2例因高龄或经济原因行保守治疗,22例行双股动脉切开取栓,2例腹主动脉切开取栓;共6例行血液滤过治疗,9例行小腿切开减张。共死亡11例,死亡原因为高钾血症导致心搏骤停及继发的急性肾衰竭;治愈15例,7例保全肢体,8例截去一侧或双侧下肢。结论早期治疗、及时手术是治疗腹主动脉骑跨栓塞的关键,早期应用血液滤过、小腿深筋膜切开减张能够降低病死率及致残率。Objective To summarize our experience in treating abdominal aorta saddle embolism（ASE）.Methods The clinical data of 26 cases of ASE were treated with Fogarty catheter and other methods during January 2000 to March 2010 were retrospectively assessed.Results 11 died because of sudden cardiac asystole due to hyperkalemia or multiple organ dysfunction syndrome secondary from acute renal failure.15 patient were cured.Of them,8 patients received amputation.Conclusion Early diagnosis and embolism removal are the key points to cure ASE.Renal replacement therapy and open decompression in lower leg can decrease the mortality and amputation rate of ASE.

关 键 词：腹主动脉 血栓栓塞 骑跨栓 取栓术 

分 类 号：R654.31[医药卫生—外科学]