急性腹主动脉骑跨栓塞诊断及治疗体会

The experience in the diagnosis and treatment of acute aortic saddle embolism

目的探讨急性腹主动脉骑跨栓塞的诊断和治疗方法。方法总结和分析12例腹主动脉骑跨栓塞治疗的临床资料,所有的患者均采用双侧股动脉切开Fogarty导管取栓治疗,其中4例合并肾功能不全者,术中辅以床边持续性肾脏替代治疗。结果11例治愈,1例截肢后仍死于肌-肾性代谢综合征。结论早期诊断、早期手术取栓治疗,合并肾功能不全者,术中床边持续性肾脏替代治疗可明显提高腹主动脉骑跨栓塞的治愈率、降低死亡率、致残率。

Objective To investigate the diagnosis and treatment of acute abdominal aorta saddle embolism. Methods Clinical data of 12 cases of acute abdominal aorta saddle embolism were reviewed and analyzed. These patients were subjected to bilateral femoral Fogarty catheter thrombolectomy. In 4 cases complicated with renal inadequacy, continuous renal replacement therapy （CRRT） during opeation was given. Results Eleven cases were cured. Five cases were amputated one or both extremities, and one patient died of renal metabolism syndrome after amputation. Conclusion Early diagnosis, operation, CRRT during operation in the patients complicated with renal inadequacy can obviously approve the healing rate and lower the mortality and the disability rate of abdominal aorta saddle embolism.