急性下肢缺血的临床治疗进展  

Progress in clinical treatment of acute lower limb ischemia

作　　者：刘辉[1] 谷岩[1] 何菊[1] LIU Hui;GU Yan;HE Ju(Vascular Surgery,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院血管外科,天津300192

出　　处：《中国城乡企业卫生》2021年第12期37-40,共4页Chinese Journal of Urban and Rural Enterprise Hygiene

基　　金：天津市卫生局科技基金(2015KZ033)。

摘　　要：急性下肢缺血(ALLI)是血管外科医生经常遇到的一种可能会带来严重后果的疾病。ALLI主要包括急性动脉栓塞和下肢急性动脉血栓形成。下肢动脉缺血不仅可能导致受累肢体坏死,还会引发全身电解质紊乱、酸碱失衡以及其他异常情况,甚至危及生命。同时,肢体恢复血运后所出现的缺血再灌注损伤可能造成更多毒素的释放,引起严重的并发症。因此,ALLI是血管外科医生所面临的重大挑战,其治疗一直成为人们关注的焦点。近年来,随着血管外科医生对下肢动脉缺血的认识更加深入、全面,血管外科技术不断发展,各种治疗方法也不断更新,尤其是减容理念的提出、不同原理的新型腔内器具的应用,包括Rotarex机械血栓切除系统和AngioJet血栓清除系统,使更多患者获得有效治疗的希望。本文将临床常用的治疗ALLI的进展进行综述,以期提高对ALLI治疗的认识。Acute lower limb ischemia(ALLI)is a disease that vascular surgeons often encounter,which may bring serious consequences. ALLI mainly includes acute arterial embolism and acute arterial thrombosis of limbs. Limb arterial ischemia will not only threaten limb survival,but also lead to systemic electrolyte disorder,acid-base disorder and other abnormalities,even life-threatening situations. At the same time,the ischemia-reperfusion injury that occurs after the limbs have regained blood supply may cause more toxins to be released and cause serious complications. Therefore,ALLI is a major challenge for vascular surgeons. Its treatment has always been the focus of people’s attention. In recent years,with a deeper and more comprehensive understaanding of lower extemity arterial ischemia by vascular surgeon and the continuous development of vascular surgery technology,various treatment methods are constantly updated. In particular,the proposition of the concept-debulking and the emergence of new endoluminal devices with different principles,including the Rotarex mechanical thrombectomy system and the AngioJet thrombectomy system,brings hope of effective treatment to patients. This paper reviews the progress of commonly used clinical treatment of ALLI,in order to improve the understanding of ALLI.

关 键 词：急性下肢缺血 治疗 导管溶栓 经皮腔内机械血栓切除术 

分 类 号：R654.4[医药卫生—外科学]