腹主动脉骑跨栓塞的外科治疗

Surgical treatment for abdominal saddle embolism

目的回顾对 2 0例腹主动脉骑跨栓塞患者的诊治经验 ,总结出一套行之有效的治疗方法。方法经双侧股动脉 Fogarty导管取栓术 9例 ,经腹取栓术 11例。结果 2 0例患者手术后共死亡 6例 ,手术病死率 3 3 %。其中经双侧股动脉取栓者病死率 11.1% ,经腹取栓者病死率 45 .5 %。术后 3例共 3条肢体因缺血坏死行截肢术。经平均 14 .1年随访 ,除 4例死于原发心脏病外 ,余 10例共 19条肢体无严重血液循环障碍。结论根据患者病情的不同采取相应的术式是必要的 ,而及时准确的诊断及采用经双侧股动脉 Fogarty导管取栓术可明显降低手术病死率。

Objective To study retrospectively the availability of embolectomy for abdominal saddle embolism.Methods Transfemoral embolectomy was performed in 9 cases and transaortic embolectomy in 11 cases.Results 6 of 20 cases died in postoperation with mortality rate of 33%,in that mortality rate of 45.5% was in cases with transaortic embolectomy and 11.1% with transfemoral embolectomy.Amputations were required in 3 of 14 survivors.4 died of heart diseases and 1 limb was dysfunctional in 14 year follow up periods.Conclusion Prompt diagnosis and proper transfemoral embolectomy are helpful to reduce mortality.