介入治疗急性下肢动脉栓塞的临床研究  

Clinical study of interventional therapy for acute lower extremity arterial embolism

作　　者：何景良[1] 梁志会[1] 李亮[1] 刘晶磊[1] HE Jingliang;LIANG Zhihui;LI Liang;LIU Jinglei(Department of Vascular Surgery,PLA Bethune International Peace Hospital,Hebei Province,Shijiazhuang 050082,China)

机构地区：[1]解放军白求恩国际和平医院血管外科,河北石家庄050082

出　　处：《中国医药导报》2018年第25期71-74,共4页China Medical Herald

基　　金：河北省医学科学研究重点课题计划指令项目(20150007)

摘　　要：目的探讨介入治疗急性下肢动脉栓塞的临床效果。方法选择2016年6月~2017年6月解放军白求恩国际和平医院诊治的急性下肢动脉栓塞60例,按照治疗方式的不同分为两组,其中对照组30例行大腔导管抽吸血栓治疗,实验组30例行大腔导管抽吸血栓+置管溶栓治疗。比较两组治疗效果和两组患者凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及D-二聚体(D-D)水平,观察两组患者的复发率及截肢率。结果治疗后,实验组总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗后,两组APTT及PT水平均高于治疗前,且实验组显著高于对照组,差异有统计学意义(P<0.05);两组FIB、D-D水平均明显低于治疗前,且实验组明显低于对照组,差异有统计学意义(P<0.05)。治疗后,实验组栓塞复发发生率低于对照组,差异有统计学意义(P<0.05),两组截肢率比较差异无统计学意义(P>0.05)。结论临床中对急性下肢动脉栓塞患者应用大腔导管抽吸血栓+置管溶栓治疗效果显著,且并发症少,临床效果优于单纯应用大腔导管抽吸血栓治疗,可进行推广。Objective To investigate the clinical efficacy of interventional therapy for acute lower extremity arterial embolism. Methods From June 2016 to June 2017, in PLA Bethune International Peace Hospital, 60 patients with acute arterial embolism of lower extremity were selected, according to the treatment methods, they were divided into two groups, 30 cases in the control group were treated with large cavity catheter sucking thrombus, and 30 cases in the experiment group were treated with large cavity catheter sucking thrombolytic thrombolysis plus catheter thrombolytic therapy. The treatment effect, prothrombin time（PT）, activated partial thromboplastin time（APTT）, fibrinogen（FIB）and D-Dimer（D-D） level of the two groups were compared, and the recurrence rate and amputation rate of the two groups were observed. Results After treatment, the total effective rate of experiment group was significantly higher than that of control group, the difference was statistically significant（P 〈 0.05）. After treatment, the levels of APTT and PT in the two groups were higher than those before treatment, and those in the experiment group were significantly higher than those of control group, the differences were statistically significant（P 〈 0.05）, and the levels of FIB and D-D in the two groups were significantly lower than those before treatment, and those in the experiment group were significantly lower than those of control group, the differences were statistically significant（P 〈 0.05）. After treatment, the incidence of embolic recurrence in the experiment group was lower than that of control group, the difference was statistically significant（P 〈 0.05）. There was no significant difference in amputation rate between the experiment group and control group（P 〉 0.05）. Conclusion The clinical effect of large cavity catheter suction thrombolysis plus catheter thrombolysis for patients with acute lower extremity arterial embolization is remarkable, and the complications are few, the clinical

关 键 词：急性下肢动脉栓塞 介入治疗 大腔导管抽吸血栓 置管溶栓 

分 类 号：R654.4[医药卫生—外科学]