经股动脉溶栓治疗下肢动脉急性栓塞

Transfemoral Artery Thrombolysis for the Treatment of Acute Occlusion of Lower-extremity Artery

目的 :探讨经股动脉溶栓等内科综合措施治疗腊国动脉以下部位急性动脉栓塞的效果。方法 :对 15例该部位动脉急性栓塞患者采用穿刺患侧股动脉滴注尿激酶或重组组织型纤溶酶元激活剂 (rt PA)进行溶栓 ,结合抗凝、扩管等治疗。结果 :本组 12例血管再通 ,溶栓再通率 80 0 % ;尿激酶再通率 6 6 7% (4 6 ) ,rt PA 88 9% (8 9) (P >0 0 5 )。溶栓 72h未再通者继续溶栓仍未再通。本组未发生肢体坏疽及出血并发症 ,患肢运动功能完全恢复。结论 :经股动脉溶栓治疗对腊国动脉以下部位的单支动脉急性栓塞效果良好 。

Objective:To investigate the therapeutic effect of comprehensive medical treatment including transfemoral artery thrombolysis for acute occlusion of lower-extremity artery.Methods:Fifteen patients with demonstrated acute occlusion of lower-extremity artery were treated with the thrombolytic therapy by puncturing femoral artery in the lesion side of lower-extremity to drip urokinase or rt-PA intra-arterially,combining with anticoagulation and vasodilator therapy. Results:Recanalization was successful in 12 of 15 cases treated with thrombolytic therapy.The recanalization rate was 80.0%,66.7%(4/6)in urokinase and 88.9%(8/9)in rt-PA(P>0.05).The patients with no recanalization after 72 hours thrombolytic therapy were treated with thrombolysis,still resulting in no recanalization.Motor function of disa- bility limbs recovered completely in all the patients,without limb gangrene or hemorrhage.Conclusion: For cases of single branch inferior to the popliteal artery,the transfemoral artery thrombolysis is an effective method.Re-occlusion can be prevented effectively combining with long-time anticoagulation.