介入取栓联合替罗非班治疗急性下肢动脉栓塞的临床疗效分析  

Analysis of the Efficacy of Interventional Thrombectomy Combined with Tirofiban in the Treatment of Acute Lower Extremity Arterial Embolism

作　　者：萧剑彬[1] 林少芒[1] 张智辉[1] 李强[1] 艾文佳[1] 刘金铃[1] 

机构地区：[1]广州医科大学附属第二医院血管外科,广东广州510260

出　　处：《中外医疗》2014年第8期36-37,89,共3页China & Foreign Medical Treatment

基　　金：广东省医学科研基金立项(A2012254)

摘　　要：目的探讨介入取栓联合替罗非班在治疗急性下肢动脉栓塞的临床疗效及安全性。方法随机选取该院于2011年4月—2012年3月收治的急性下肢动脉栓塞患者52例(76肢)随机分为两组,对照组26例行Fogarty导管取栓术,治疗组26例患者除给予介入取栓外,术前术后给予替罗非班预防血栓形成,根据治愈率、死亡率、术后再栓率以及截肢率评价两组方法的疗效。结果两组患者均成功取除大部分栓子,无死亡病例;治疗组和对照组的治愈率、术后再栓率以及截肢率分别为92.1%(35/38)和78.9%(30/38)、7.9%(3/38)和21.0%(8/38)、2.6%(1/38)和13.2%(5/38),差异有投机学性意义(P<0.01)。未发生出血等不良反应。结论 Fogarty导管取栓术联合替罗非班对治疗急性下肢动脉栓塞的临床疗效及安全性均较好,且提升了手术成功率,具有较强的临床应用价值,值得临床推广。Objective To investigate the clinical efficacy and safety of interventional thrombectomy combined with tirofiban in the treatment of acute lower extremity arterial embolism.Methods 52 cases of patients（76 limbs）with acute lower extremity arterial embolism admitted in our hospital from April, 2011 to March,2012 were randomly divided into treatment group （n=26）and control group（n=26）.The control group was treated with Fogarty catheter embolectomy.Besides interventional thrombectomy, the treatment group was given tirofiban preoperatively and postoperatively for preventing the formation of thrombus. The clinical efficacy of the two groups was evaluated by cure rate, mortality,postoperative embolism relapse rate and amputation rate.Results Most thrombi in 62 cases were removed, and no death case.The cure rate, postoperative embolism relapse rate and amputation rate of the treatment group and the control group were 92.1%（35/38） and 78.9%（30/38）, 7.9%（3/38） and 21.0%（8/38）,2.6%（1/38）and 13.2%（5/38）,respectively,and the differences between the two groups were statistically significant（P〈0.01）. And no bleeding and other adverse reactions occurred.Conclusion Fogarty catheter embolectomy combined with tirofiban is effective and safe in treating acute lower extremity arterial embolism, which can increase the success rate of the surgery with high clinical value, and is worthy to be recommended.

关 键 词：下肢动脉急性栓塞 FOGARTY导管取栓术 替罗非班 临床疗效 

分 类 号：R543.5[医药卫生—心血管疾病]