动脉内接触性溶栓联合球囊及支架成形术在亚急性下肢动脉闭塞性病变中的应用  

Application of Intraarterial Catheter Directed Thrombolysis Combined with Balloon and Stent Angioplasty in Treatment of Subacute Lower Limbs Artery Occlusion

作　　者：田锦林[1] 王伟[1] 李云松[1] 杜亚辉[1] 郭跃辉[1] 李春雷[1] 陈硕飞[1] 

机构地区：[1]解放军252医院介入血管外科,河北保定071000

出　　处：《解放军医药杂志》2013年第4期36-39,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的评价动脉内接触性溶栓(intraarterial catheter directed thrombolysis,ICDT)联合球囊及支架成形术在亚急性下肢动脉闭塞性病变中的应用效果。方法 2009年12月—2011年6月对13例(18处)亚急性下肢动脉闭塞性病变,先行ICDT,再联合球囊及支架成形术,观察溶栓效果和血管再通情况。结果本组溶栓总有效率为94.44%。尿激酶用量(211.54±84.54)万单位;溶栓后缺血症状改善,肢体皮肤温度回升,静息痛有不同程度的好转,无垃圾脚发生。球囊及支架成形术后踝肱指数(ABI)由术前的(0.38±0.11)升高至(0.89±0.07),差异有统计学意义(P<0.01)。结论 ICDT能够溶解部分血栓,显露血管真正狭窄范围,减少支架放置数目,缩短支架长度,从而降低血管再狭窄风险及节约医疗成本。Objective To evaluate the effect of intraarterial catheter directed thrombolysis （ICDT） combined with balloon and stent angioplasty in treatment of subacute lower limbs artery occlusion. Methods Thirteen patients （ 18 places） with subacute arterial occlusion lesions of lower limb during December 2009 and June 2011 firstly underwent ICDT, then balloon and stent angioplasty was performed. The efficacy of thrombolysis and reeanalization rate was retro- spectively analyzed. Results The total efficacy rate of thrombolysis was 94.44%. The urokinase dose was （211.54 ± 84.54） million units. After ICDT, ischemia symptoms improved, limb skin temperature returned and rest pain certainly relieved without garbage feet occurrence in all patients. After combined treatment of balloon and stent angioplasty, the an kle/brachial index （ABI） was increased from pre-procedure （0.38 ± 0.11 ） to post-procedure （0.89 ± 0.07 ） , and the difference was statistically significant （P 〈 0. 05）. Conclusion ICDT may dissolve part thrombus, show real vascular stenosis range and reduce amount and length of stent placement, which will accordingly decrease restenosis occurrence and medical costs.

关 键 词：下肢 动脉闭塞性疾病 血栓溶解疗法 血管成形术 气囊 支架 

分 类 号：R654.3[医药卫生—外科学]