急性肢体动脉栓塞的早期诊治

The early diagnosis and management of acute arterial embolism in the lower extremity

目的 探讨急性肢体动脉栓塞的早期诊治。方法 总结 35例急性肢体动脉栓塞的诊治经验。栓塞原因 :心源性 2 3例 (66 9% ) ,其中房颤 1 9例 (54 3 % ) ,动脉硬化 6例 (1 7 1 % ) ,血管损伤 3例 (8 5 % ) ,不明原因 3例 (8 5 % )。栓塞部位 :1 7例(48 6 % )股动脉 ,6例 (1 7 1 % )动脉 ,5例 (1 4 7% )髂动脉 ,4例 (1 1 6 % )动脉远端 ,2例 (5 7% )肱动脉 ,1例 (2 8% )腹主动脉跨栓。治疗方法 :1 2例Fogarty导管取栓 ,1 1例溶栓抗凝治疗 ,3例人工血管搭桥 ,6例截肢 ,3例自动出院。 结果 治愈 2 2例(62 9% ) ,改善 4例 (1 1 4% ) ,截肢 6例 (1 7 1 % ) ,自动出院 3例 (8 6 % )。结论 急性肢体动脉栓塞早期诊断 ,及时取栓和溶栓抗凝综合治疗是降低截肢率 。

Objective To explore the early diagnosis and management of acute arterial embolism in the lower extremity.Methods A review of 35 acute arterial occlusion.The major cause of heart disease origin were 23 cases(66.9%),arterial fibrillation were present in 19 cases(54.3%).The main embolism present in femoral artery 17 cases (48.6%),popliteal artery 6 cases (17.1%).Embolectomy performed on 12 patients by Fogarty catheter, 3 patients were implanted by artifical vascular grafting. The use of thrombolysis and anticoagulants were 11 patients.Results excellent 22 cases(62.9%),good 4 cases (11.4%), amputation 6 cases (17.1%).Conclusion Early diagnosis and embolectomy using Fogarty catheter, together with antiaglutinative and antithrombofic therapy,is a key to gain a effective results.