伴发血小板减少症的下肢动脉栓塞围手术期治疗

Perioperative therapeutical strategies of arterial embolism of lower limbs associated with thrombocytopenia

目的:探讨伴发血小板减少症的下肢动脉栓塞围手术期的治疗。方法:回顾性分析2008-12-2011-10期间手术取栓的5例伴发血小板减少症的下肢动脉栓塞患者的临床资料。结果:5例患者均手术成功,无创面渗血。1例取栓后急性肾功能不全;2例患者再次动脉栓塞后肢体坏死截肢。随访18个月(4个月～27个月),1例19个月后死于晚期胃癌,其余病例生活状态良好。结论:血小板减少不是急诊动脉取栓手术的绝对禁忌症;根据具体的情况调整治疗方案,创造条件尽早手术是十分重要的。

Objective：To explore the perioperative therapeutical strategiestreatments of arterial embolism associated with thrombocytopenia perioperatively.Method：Retrospective analysis of clinical data in 5 patients with arterial embolism associated with thrombocytopenia were preformed from Aug.2008 through Oct.2011.Result：Surgical eEmbolectomy was successfully performed in all 5 patients without blood oozing.Acute renal insufficiency was seen in 1 case after embolectomy.Lower limbs were amputated in 2 cases due to repeated arterial embolism.At a median follow up of 18 months（range,4-27）,1 patient died of advanced gastric cancer after 19 months and others were cured of their symptoms.Conclusion：Thrombocytopenia with arterial embolism is not absolute contraindication for urgent arterial embolectomy.The effective and comprehensive treatments in perioperative period are very important for succeeding operation.