非心源性急性下肢动脉缺血的临床诊疗体会

Diagnosis and Treatment of Acute Lower Limb Ischemia due to Non-cardiogenic Embolism

目的探讨非心源性原因导致的急性下肢动脉缺血的临床经验与诊疗体会。方法对52例不同病因引起的急性下肢动脉缺血的患者分别采取了具有针对性的诊断与治疗,如经股动脉入路切开取栓术、动脉硬化斑块切除+经股动脉切开取栓术、取自体血管(大隐静脉)或人工血管进行移植重建术、股静脉切开取栓术、损伤动脉修复、吻合术及髂动脉开窗手术。结果本组无死亡病例,3例患者截肢,49例患者肢体得到救治,术后平均随访21个月。结论非心源性原因所导致的急性下肢动脉缺血,其诊断与治疗有着一定的复杂性和困难性,我们实际可以认为急性下肢动脉缺血是诸多疾病的一个共同并发症。

Objective To explore the clinical experience in the treatment of acute lower limb ischemia due to non-cardiogenic embolism. Methods The relevant diagnosis and treatment such as thrombectomy via percutaneous femoral arterial approach,re- section of atherosclerotic plaques ＋ thrombectomy via percutaneous femoral arterial approach,transplantation and reconstruction with autologous or artificial blood vessel, thrombectomy via femoral vein approach, repair of damaged blood vessels, vessel anasto- mosis and fenestration of iliac artery were performed in 52 patients with acute lower limb ischemia due to non-cardiogenic embol- ism. Results There was no death patients in this group. 3 patients underwent limb amputation,49 patients were cured. The aver- age time of follow-up was 21 months. Conclusion The diagnosis and treatment of acute lower limb ischemia due to non-cardio- genic embolism are still with complexity and difficulty. To some extent, it can be considered as a common complication of many non-cardiogenic embolism.