高龄患者急性下肢缺血的围手术期治疗(附43例报告)  

Surgical treatment of acute lower limb ischemiain eldly patients(43 cases)

作　　者：姜云飞[1] 朱云峰[1] 吴元兵[1] 朱永斌[1] 葛红卫[1] 陈诚[1] 郑亮[1] 

机构地区：[1]苏州大学附属第三医院(常州市第一人民医院),江苏常州213003

出　　处：《中外医学研究》2011年第10期1-2,共2页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的 探讨高龄患者急性下肢缺血的围手术期治疗的注意要点。方法 回顾分析2008年1月～2009年12月因急性下肢缺血住院治疗的高龄患者43例的临床资料。结果 40例术前诊断急性动脉栓塞的患者急诊行单纯Fogarty导管取栓术。其中，35例术中证实为栓塞，取栓后预后良好（有效率87．5％）；3例术后多脏器功能衰竭死亡（病死率7％）；另外5例术中证实为动脉硬化狭窄伴急性血栓形成，3例行截肢术，围手术期截肢率高达7％。3例术前诊断下肢动脉急性血栓形成的患者，经溶栓治疗后症状缓解。结论 对于患急性下肢动脉缺血疾病的高龄患者，Fogarty导管取栓术加溶栓治疗是治疗此疾病的主要方法，同时应积极预防和治疗术中及术后并发症。Objective To evaluate surgical treatment of acute lower limb ischemia in eldly patients. Methods From January 2008 to December 2009, 43 old patients with acute lower limb iscbemia were treated, and the clinical data were retrospectively analyzed. Results Fogarty catheter embolectomy was performed in 40 patients. 35 patients proved to be embolism intra - operatively and the effective rate was 87.5% ; 3 patients died due to MODS （mortality7%） ;In addition, 5 cases were considered to be arteriosclerosis and thrombosis, 3 patients were amputated （7%）. By contrast, the symptoms of 3 patients who were relivied by thrombolysis. Conclusion Fogarty catheter embolectomy is adequate in the treatment of acute arterial embolism in eldly patients, and appropriate measures are important peri - operatively for complication treatment.

关 键 词：急性下肢缺血 FOGARTY导管取栓术 溶栓 

分 类 号：R654.4[医药卫生—外科学]