121例急性肢体缺血患者的单中心研究  

A single-center study of 121 cases of acute limb ischemia patients

作　　者：代江红 林子鹏 余培东 刘勇 何虎强 Dai Jianghong;Lin Zipeng;Yu Peidong;Liu Yong;He Huqiang(Department of Vascular Surgery,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China)

机构地区：[1]西南医科大学附属医院血管外科,四川泸州646000

出　　处：《血管与腔内血管外科杂志》2025年第2期166-170,共5页Journal of Vascular and Endovascular Surgery

基　　金：四川省医学会静脉栓塞栓塞症防治专项科研项目(2019HR10)。

摘　　要：目的探讨急性肢体缺血(ALI)患者的治疗效果。方法收集2015年4月至2017年12月于西南医科大学附属医院接受手术治疗的121例ALI患者的临床资料,比较传统切开取栓术、经导管直接溶栓(CDT)及两者联合治疗ALI的截肢率、生存率。结果传统切开取栓患者11例,术后30天内截肢率、6个月生存率、12个月生存率分别为18.1%(2/11)、81.8%(9/11)、63.6%(7/11)。CDT治疗患者93例,术后30天内截肢率、6个月生存率、12个月生存率分别为4.3%(4/93)、86.0%(80/93)、80.6%(75/93)。传统切开取栓联合CDT治疗患者17例,术后30天内截肢率、6个月生存率、12个月生存率分别为5.9%(1/17)、94.1%(16/17)、82.4%(14/17)。三种治疗方法术后30天内截肢率、6个月生存率、12个月生存率比较,差异均无统计学意义(P﹥0.05)。CDT治疗患者出血并发症比例较高,为3.2%(3/93),其他治疗并未发现出血并发症。结论CDT治疗ALI的疗效确切,但实际临床工作中需关注其出血风险,根据患者的具体病变特点选择适当的干预措施尤为重要。Objective To investigate the therapeutic effect of acute limb ischemia(ALI).Method Clinical data of 121 patients with ALI who received surgical treatment in the Affiliated Hospital of Southwest Medical University from April 2015 to December 2017 were collected.The amputation rate and survival rate of ALI treated by traditional thrombectomy,transcatheter-directed thrombolysis(CDT)and combined treatment were compared.Result In 11 patients with traditional thrombolectomy,the amputation rate within 30 days after surgery,6-month survival rate and 12-month survival rate were 18.1%(2/11),81.8%(9/11)and 63.6%(7/11),respectively.In 93 patients treated with CDT,the amputation rate within 30 days,6-month survival rate and 12-month survival rate were 4.3%(4/93),86.0%(80/93)and 80.6%(75/93),respectively.In 17 patients treated with conventional thrombolectomy combined with CDT,the amputation rate within 30 days,6-month survival rate and 12-month survival rate were 5.9%(1/17),94.1%(16/17)and 82.4%(14/17),respectively.There were no significant differences in amputation rate within 30 days after surgery,6-month survival rate and 12-month survival rate among three treatment methods(P>0.05).Conclusion The efficacy of CDT in the treatment of ALI is accurate,and appropriate intervention measures should be selected according to the specific pathological characteristics of patients.

关 键 词：急性肢体缺血 经导管直接溶栓 切开取栓 杂交手术 

分 类 号：R543[医药卫生—心血管疾病]