主髂动脉栓塞15例外科治疗

Surgical treatment of ilioabdominal aorta embolism:report of 15 cases

作者近6年来收治的主髂动脉栓塞患者15例,其中腹主动脉骑跨栓6例,右髂动脉栓塞6例,左髂动脉栓塞3例。9例有心脏疾患病史,其中风心病并发房颤5例、冠心病4例。发病时间为2～11天,术前均经动脉造影诊断。主要治疗方法为腹主动脉切开取栓,经股动脉切开 Fogarty 导管取栓,髂-股动脉人造血管旁路移植术。治疗结果11例成功、4例失败,其中1例死于取栓术后急性肾功能衰竭。作者强调:栓塞发生后手术施行得愈早效果愈好,最好争取在发病后6～8小时施行手术。

Fifteen cases of ilioabdominal aorta embolism were treated during a period of six years including straddle thrombus in 6 cases,thrombus of right ilional artery in 6,and of left ilional artery in 3.Nine had a history of heart disease.Time elapsed from onset to definite treat- ment was between 2 and 11 days.Diagnosis was identi- fied all by angiography.Patients were treated accordingly by direct thrombectomy perabdominal aorta,by Fogarty catheter transfemorally,or iliofemoral bypass.Eleven were cured and 4 failed.It is the authors' belief that the best timing for thrombectomy is between 6 to 8 hours af- ter onset.