慢性周围动脉闭塞的选择性动脉内溶栓治疗  

Selective intravascular thrombolysis for treatment of chronic peripheral arterial occlusion

作　　者：戚跃勇[1] 戴书华[1] 邹利光[1] 宋跃明[2] 黄岚[2] 王旭开[2] 朱结辉[3] 

机构地区：[1]第三军医大学附属新桥医院放射科,重庆400037 [2]第三军医大学附属新桥医院心内科,重庆400037 [3]第三军医大学西南医院放射科,重庆400038

出　　处：《医学影像学杂志》2004年第2期125-127,共3页Journal of Medical Imaging

摘　　要：目的 :探讨慢性周围动脉闭塞的选择性动脉内溶栓治疗价值。方法 :36例慢性周围动脉闭塞中 ,男 19例 ,女17例。年龄 38～ 6 9岁 ,平均 4 8.5± 6 .8岁。右下肢 11例 ,左下肢 16例 ,左上肢 6例 ,右上肢 3例。按治疗方式分为 3组 ,常规动脉内导管药物溶栓者 16例 (A组 ) ,改良动脉内导管药物溶栓者 12例 (B组 ) ,超声溶栓结合导管内药物溶栓者 8例(C组 )。溶栓后球囊成形者 13例 ,同时行内支架植入者 4例。结果 :36例慢性周围动脉闭塞均溶栓成功 ,无 1例产生并发症。A、B、C三组的平均溶栓时间分别为 18.4± 5 .8h ,9.6± 3.2h和 8.5± 2 .8h ,C组的溶栓时间明显短于A、B组 (P <0 .0 5 )。A、B、C三组的平均尿激酶量分别为 10 6 .8± 38.5万u ,112 .5± 2 5 .6万u和 4 5 .6± 12 .5万u ,C组的平均尿激酶用量明显少于A、B组 (P <0 .0 5 )。结论 :选择性动脉内溶栓治疗是慢性周围动脉闭塞的安全有效的治疗方法。Objective:To explore the value of selective intravascular thrombolysis of the chronic peripheral arterial occlusion.Methods:Thirty-six patients (19 men,17 woman;aged 38-69;average age,48±6.8) were divided into three groups,involving right lower limb in 11 cases,left lower limb in 16 cases,left upper limb in 6 cases,right upper limb in 3 cases.Sixteen patients were treated with traditional intravascular thrombolysis in Group A, and 12 patients with the improved intravascular thrombolysis in Group B.Group C were administrated from artery with ultrasound thrombolysis, combined with traditional intravascular thrombolysis in 8 patients. Thirteen patients were managed with PTA after thrombolysis and 4 patients with stent placement at the same time. Results:Occluded arteries were recanalized successfully in all cases without any complication. The mean time of thrombolysis of the Group A,B and C was 18.4±5.8,9.6±3.2 and 8.5±2.8 hours, respectively. The mean time of Group C was shorter than that of the other groups (P<0.05).The mean dose of urokinase (UK) of the Group A,B and C was 1068000±385000, 1125000±256000 and 456000±125000U, respectively. The mean dose of UK of Group C was less than that of the other groups (P<0.05).Conclusion:Selective intravascular thrombolysis is a safe and effective treatment method for the chronic peripheral arterial occlusion.

关 键 词：动脉闭塞性疾病 超声溶栓 尿激酶 放射学 介入性 

分 类 号：R543.5[医药卫生—心血管疾病] R815[医药卫生—内科学]