急性腹主动脉骑跨栓塞二例纠误挽治体会  

Corrective Misdiagnosis and Salvage Therapy of 2 Patients with Acute Abdominal Aorta Straddle Embolism

作　　者：武欣[1] 李学峰[1] 郭连瑞[1] 佟铸[1] 郭建明[1] 张建[1] 谷涌泉[1] 

机构地区：[1]首都医科大学宣武医院血管外科,北京100053

出　　处：《临床误诊误治》2012年第11期14-17,共4页Clinical Misdiagnosis & Mistherapy

基　　金：国家高技术研究发展计划(863计划)(2012AA020507)

摘　　要：目的探讨急性腹主动脉骑跨栓塞(abdominal aorta saddle embolism,ASE)的诊疗要点,提出防范误诊误治措施。方法回顾分析2例以下肢缺血为主要表现的急性ASE临床资料。结果 2例均以下肢缺血为主要表现,1例误诊为腰椎间盘突出症,另1例误诊为脑血管病后遗症。例1经腹主动脉、下肢动脉超声及血管造影检查确诊为急性ASE,例2根据患者典型症状及体征、CT检查结果诊断为急性ASE。2例均行介入导管溶栓治疗,因延误治疗导致肢体坏死,均行右下肢膝上截肢术。结论提高对急性ASE的认识,早期注意鉴别诊断,可降低截肢率和病死率。Objective To investigate clinical manifestations of acute abdominal aorta straddle embolism （ASE） in order to prevent misdiagnosis. Methods Clinical data of 2 patients with acute straddle embolism in abdominal aorta by lower limb ischemia were retrospectively analyzed. Results The main symptoms were manifested by lower limb ischemia. One was misdiagnosed as hav- ing lumbar disc herniation; the other was misdiagnosed as having sequelae of cerebrovascular disease. ASE was definitely finally di- agnosed for the first patient by abdominal aorta and lower extremity artery ultrasound and angiography, and the other was definitely diagnosed by typical symptoms, signs and CT examination. Interventional catheter thrombolytic therapy was performed in the 2 patients, who patients underwent above knee amputation in right lower extremity due to delay and necrosis in both limbs. Conclusion We should improve awareness of ASE in order to diagnose early and reduce amputation and mortality rates.

关 键 词：主动脉 腹 栓塞 误诊 椎间盘移位 脑血管意外 

分 类 号：R654.3[医药卫生—外科学]