双点穿刺阻流取栓与单纯导管吸栓治疗急性下肢动脉栓塞的对比研究

Comparison of obstructing blood flow interventional embolectomy and simple interventional embolectomy for acute lower limb arterial embolism

目的探讨、比较单纯导管吸栓法和双点穿刺阻流取栓法治疗下肢动脉急性栓塞的疗效;评价双点穿刺阻流取栓法的治疗价值。方法总结和分析2004年1月-2007年4月收治的79例急性下肢动脉栓塞患者的临床资料:其中单纯导管吸栓法治疗56例,经皮双点穿刺阻流取栓法治疗23例。结果79例下肢动脉急性栓塞患者均采用介入方法成功去除栓子,开通动脉。单纯导管吸栓法治疗组术后截肢(趾)率19.6%(11/56),病死率5.4%(3/56);双点穿刺阻流取栓法治疗组截肢(趾)率8.7%(2/23),病死率4.3%(1/23)。结论经皮双点穿刺阻流取栓术治疗下肢动脉急性栓塞,是一种简便有效的方法,与传统的单纯吸栓术相比,病死率差别无统计学意义,但截肢(趾)率明显下降,且术后恢复快,总体花费少。

Objective To evaluate the effects （mortality, amputation rate, the length and expense of hospital stay, etc）of the obstructing blood flow interventional embolectomy and simple interventional embolectomy for acute lower limb arterial embolism. Methods 79 cases of acute lower limb arterial embolism including 23 cases of two sites puncturing and obstructing blood flow interventional embolectomy and 56 cases treated by simple interventional embolectomy were retrospectively analyzed and compared. Results Embolisms were removed in all 79 cases and arteries were reopened successfully. The mortality and the amputation rates of the simple and the obstructing blood flow embolectomies were 5.36%, 19.6%, and 4.35%, 8.70% respectively. Conclusion Two sites puncturing and obstructing blood flow interventional embolectomy for acute lower limb arterial embolism is simple, safe and effective, compari^ng with the simple interventional embolectomy, with lower amputation rate, quicker recovery and lower expense, however with no statistical significance in mortalities.