腹主动脉瘤术后急性严重下肢动脉缺血

Clinical analysis of acute lower limb ischemia after abdominal aortic aneurysm operation.

目的 探讨腹主动脉瘤 (AAA)手术合并急性下肢动脉缺血的病因、预防和治疗。方法 对 1979～2 0 0 1年AAA术后急性下肢动脉缺血 6例临床资料进行回顾性分析。结果 6例均经手术治疗。 5例行股动脉切开、Fogarty管取栓术 ,3例行再次开腹探查 ,取栓或旁路术。肢体保存 3例 ,因合并多器官系统功能衰竭 (MOSF)死亡 3例。结论 避免动脉硬化斑块脱落和防止血栓形成是预防急性下肢动脉缺血的关键 。

Objective To investigate the etiology, prevention and treatment of acute lower limb ischemia following the operation of abdominal aortic aneurysm (AAA).Methods Clinical data of the six patients with AAAs who underwent surgical repairs and developed acute lower limb ischemia were retrospectively analyzed.Results Six cases were managed with operations. Five cases underwent the operations of thrombectomy or embolectomy with Fogarty catheter. Three cases had the second operations of laparotomy, thrombectomy and arterial bypass. Three limbs survived.Three cases developed multiorgan systemic failure (MOSF) and eventually died.Conclusion Avoiding dislodgment of the atheromatous debris and preventing thrombosis are the key points in preventing the occurrence of acute lower limb ischemia,and can improve the survival rate of AAA operation.