导管溶栓在亚急性期下肢动脉闭塞症治疗中的疗效分析  

Analysis of curative effect of catheter thrombolysis in the treatment of subacute lower limb arterial occlusion

作　　者：赵凯[1] 孙顺吉[1] 蹇兆成[1] 王秀春[1] 王鹏[1] Zhao Kai;Sun Shunji;Jian Zhaocheng;Wang Xiuchun;Wang Peng.(Department of Vascular Surgery, Affiliated Hospital of Weifang Medical University, Shandong Weifang 261041, China)

机构地区：[1]潍坊医学院附属医院血管介入科,261041

出　　处：《中国医师进修杂志》2018年第2期140-143,共4页Chinese Journal of Postgraduates of Medicine

基　　金：潍坊市科技发展计划项目（2016YX076）

摘　　要：目的通过应用导管溶栓联合腔内介入治疗下肢动脉闭塞症，观察导管溶栓在亚急性期下肢动脉闭塞症治疗中的临床疗效。方法对85例亚急性期下肢动脉闭塞症患者（98条肢体），先采取导管溶栓方法，造影评估血栓去除情况及血管开通情况。然后根据溶栓后造影情况，进一步行球囊扩张或支架植入术。结果行导管溶栓的98条肢体，溶栓后血管闭塞程度、闭塞段长度均显著改善，与溶栓前比较差异有统计学意义（P 〈 0.01）。导管溶栓后显著有效5条肢体（5.1%），有效85条肢体（86.7%），无效8条肢体（8.2%），总有效率为91.8%。根据溶栓后血管闭塞情况，行球囊扩张和/或支架植入治疗，术后闭塞段管腔均开通，术后造影显示无远端血管闭塞，无支架内血栓形成。无出血事件发生。结论导管溶栓在亚急性期下肢动脉闭塞症治疗中是有效且安全的，联合血管腔内治疗可达到良好的治疗效果。ObjectiveTo observe the curative effect of catheter thrombolysis in the treatment of subacute lower limb arterial occlusion.MethodsEighty-five patients with subacute lower limb arterial occlusion （98 limbs） and treated with catheter thrombolysis were enrolled and the removal of thrombus and patency of vessels were evaluated by angiography. Then, balloon dilatation or stent implantation was performed according to the angiographic findings after thrombolysis.ResultsAfter catheter thrombolysis, the degree and length of occlusion were significantly improved （P 〈 0.01）. To judge the curative effect： significantly effective in 5 limbs （5.1%）, effective in 85 limbs （86.7%）, ineffective in 8 limbs （8.2%）, total effective rate was 91.8%. Catheter thrombolysis combined with balloon dilatation and stent implantation were performed according the vascular occlusion status and all the occluded segments were open, the postoperative angiography showed no distal vascular occlusion. No bleeding occurred.ConclusionsCatheter thrombolysis is effective and safe in the treatment of lower extremity arterial occlusion in subacute stage. Endovascular treatment combined with endovascular treatment can achieve good results.

关 键 词：下肢动脉闭塞症 亚急性期 导管溶栓 腔内治疗 

分 类 号：R543.5[医药卫生—心血管疾病]