导管溶栓治疗急性下肢动脉缺血的疗效评价

Therapeutic evaluation of catheter-directed thrombolysis for the treatment of acute arterial ischemia of lower extremities

目的探讨导管溶栓治疗急性下肢动脉缺血的疗效和安全性。方法收集2008年1月1日至2009年12月31日就诊于我院急性下肢动脉缺血行导管溶栓治疗的病例共56例,采用尿激酶溶栓,观察溶栓治疗的效果和并发症。结果治愈10例(17.8%),有效38例(67.9%),无效8例(14.3%),总有效率为85.7%。发生并发症11例(19.6%);与导管溶栓直接相关的并发症6例(10.7%),包括穿刺点血肿5例(8.9%)和脑畸形血管破裂出血1例(1.7%)。结论导管溶栓是治疗急性下肢动脉缺血的较为安全、有效的方法。

Objective To evaluate the therapeutic effect and safety of catheter-directed thrombolysis in treating acute arterial ischemia of lower extremities.Methods From Jan.1,2008 to Dec.31,2009,a total of 56 patients with acute arterial ischemia of lower extremities,who were encountered at the affiliated Renji hospital of Shanghai Jiaotong University,received catheter-directed thrombolysis treatment with urokinase.The therapeutic effect,safety and complications were observed and analyzed.Results Of the total 56 cases,complete cure was obtained in 10（17.8%）,effective response in 38（67.9%） and valueless in 8（14.3%） with an overall effectiveness of 85.7%.Complications occurred in 11 cases（19.6%）.The complications happened in six cases（10.7%） were directly related to the catheter-directed thrombolysis,which included hematoma at puncture site（n = 5,8.9%） and bleeding due to the rupture of cerebrovascular malformation（n = 1,1.7%）.Conclusion Catheter-directed thrombolysis is a safe and effective treatment for the acute arterial ischemia of lower extremities.