四肢军事训练伤后继发动脉血栓形成的微创治疗效果  

Effect of Micro-invasion Therapy for Secondum Arterial Thrombosis of Extremities Caused by Military Training Injuries

作　　者：赵堂海 秦少华 郭明金 解远峰 战激光 张杰 逄晓军 王立华 李梦文 

机构地区：[1]解放军107医院血管外科,山东烟台264002

出　　处：《解放军医药杂志》2015年第7期95-97,102,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨应用导管接触溶栓(CDT)治疗军事训练伤后继发动脉血栓形成的临床效果。方法 2005年3月—2013年3月解放军107医院血管外科收治四肢军事训练伤后继发动脉血栓形成43例,均给予CDT治疗,其中单纯CDT 22例,CDT+腔内球囊扩张成形(PTA)17例,CDT+PTA+支架置入4例。结果导管溶栓时间为(3.0±2.2)d。本组治愈率为74.4%,总有效率为100.0%。2例(4.7%)溶栓过程中发生二次栓塞予调整导管位置后继续溶栓,5例(11.6%)溶栓过程中发生小腿骨筋膜室综合征行骨筋膜室切开减压术,均保趾、保肢成功。43例均术后随访(48.3±19.4)个月,无症状加重或复发。结论 CDT治疗四肢军事训练伤后继发动脉血栓形成是一种安全、有效、微创的方法,适于战时伤病员的救治与后送。Objective To investigate the clinical effect of catheter-directed thrombolysis（ CDT） in treatment of secondum arterial thrombosis caused by military training injuries. Methods A total of 43 patients（ 43 limbs） with secondum arterial thrombosis caused by military training injuries during March 2005 and March 2013 underwent CDT therapy,which included 22 patients with pure CDT,17 patients with CDT ﹢ percutaneous transluminal angioplasty（ PTA）and 4 patients with CDT ﹢ PTA ＋ stent implantation. Results The CDT period was（ 3. 0 ± 2. 2） d,and the cure rate was 74. 4%,and the total effective rate was 100. 0%. Second embolism was found in 2 patients（ 4. 7%） during thrombolysis process,and the thrombolysis was continued after adjustment of the catheter position; 5 patients（ 11. 6%） underwent open decompression of compartment for osteofascial compartment syndrome of ossa cruris,and the extremities and toes were saved. All the 43 patients were followed up for an average of（ 48. 3 ± 19. 4） months,and there was no aggravation of symptoms or relapse. Conclusion CDT is a safe,effective and minimally-invasive method in treatment of secondum arterial thrombosis of extremities caused by military training injuries.

关 键 词：军事人员 急性肢体缺血 血栓形成 机械溶栓 

分 类 号：R821[医药卫生—临床医学] R654.4