置管溶栓联合腔内成形术治疗急性下肢动脉血栓形成

Indwelling catheter thrombolysis combined with angioplasty for the treatment of acute lower extremity arterial thrombosis

目的评价置管溶栓联合腔内成形术治疗急性下肢动脉血栓形成的疗效。方法 2012年1月至2016年7月,对42例下肢动脉血栓形成的患者,先急诊进行置管溶栓,3 d后造影联合腔内成形术处理狭窄段,统计治疗前后患肢踝肱指数(ankle brachial index,ABI)。结果在42例中仅4例(9.5%)行单纯性溶栓,38例(90.5%)联合球囊扩张、支架成形术;40例(95.2%)症状明显改善,2例(4.8%)血栓溶解效果欠佳,最终截肢。术后ABI的平均值为(0.62±0.13),与术前(0.15±0.06)比较,差异有统计学意义(P<0.01)。结论置管溶栓联合腔内成形术治疗急性下肢动脉血栓形成的疗效肯定,值得临床推广。

Objective To evaluate the efficacy of indwelling catheter thrombolysis combined with angioplasty for the treatment of acute lower extremity arterial thrombosis. Methods From January 2012 to July 2016, indwelling catheter thrombolysis was urgently performed in 42 cases suffering from acute lower extremity arterial thrombosis. Three days later arteriography combined with angioplasty was selectively performed in cases whose lower extremity artery had markedly stenosis. The ankle brachial index （ABI） in all cases before and after operation was observed. Results In 42 cases, only 4 cases （9.5%） underwent simple thrombolysis and other 38 cases （90.5 %） underwent thrombolysis combined balloon dilatation and stenting; 40 cases （95.2%） had significantly improved symptoms, 2 cases （4.8 %） had to be amputated finally for ineffective thrombolysis. ABI increased from （0.15 ±0.06） preoperatively to （0.62 ± 0.13） postoperatively, the difference was statistically significant （P〈 0.01）. Conclusions Indwelling catheter thrombolysis combined with angioplasty for the treatment of acute lower extremity arterial thrombosis has affirmative efficacy and it is worthy of clinical promotion.