急性下肢缺血性疾病的介入治疗

Application of Interventional Therapy in the Treatment of Acute Lower Limb Ischemic Disease

目的 探讨应用介入方法治疗急性下肢缺血性疾病的临床效果及安全性。方法 2 1例患者按基础病因不同分为两组 ,对无患肢慢性缺血史者给予单纯动脉内灌注尿激酶 ,对存在有患肢慢性缺血史者在给予适当尿激酶 30万u后 ,应用超滑导丝通过闭塞段 ,顺导丝送入球囊导管行PTA术。结果 第 1组 8例获得成功 ,1例于术后第 3天死于急性左心功能不全 ;第 2组 9例获得成功 ,3例在发病 5日后行截肢术。结论 ( 1)多种介入方法联合治疗急性下肢缺血临床效果可靠。( 2 )基础性病因是决定介入方法选择的首要因素。

Objective To discuss the clinical effect and reliability of interventional method in treating acute lower limb ischemic disease.Methods 21 patients (11 men, 6 women; aged 35-72; average age, 58) were divided into two groups according to difference of basic etiological factor. 9 patients with chronic ischemic history suffering lower limbis in the first group, only urokinase was administrated from artery. 12 patients without chronic ischemic history suffering lower limb was the second group,after delivering a quantity of urokinase (300,000 unit), guide wire was performed across the occlusive segment, then induced Foley's tube for PTA. Results In the first group, 8 patients succeeded, and one died of acute heart failure three days later; in the second group, 9 patients succeeded, and 3 patients were given amputation 5 days later.Conclusion (a) The therrapeuti effect of several interventional methods is reliable in treating acute lower limb ischemic disease;(b) Basic etiological factors are a prime element in choosing interventional method.