超声导引下Fogarty导管取栓术与切开探查术在动脉危象中应用的比较

Comparative study on the application of ultrasound-guided Fogarty catheter thrombectomy and incision exploration in arterial crisis

目的探讨超声导引下Fogarty导管取栓术、切开探查术对动脉危象的临床疗效。方法 2011年5月至2017年1月,对23例(27条血管)患者在断肢再植术后出现动脉危象予以处理,其中9例(12条血管)采用超声导引下Fogarty导管取栓术(Fogarty术式组),14例(15条血管)采用切开探查术(切开术式组)。对两组围手术期术中出血量、总手术时间、术后截肢率、术后再次栓塞率等相关指标及术后12个月随访评价患肢功能优良率进行对比分析。结果术中出血量两组间比较差异有统计学意义(P<0.05);总手术时间两组间比较差异有统计学意义(P<0.05);术后截肢率两组间比较差异有统计学意义(P<0.05);术后再次栓塞率两组间比较差异有统计学意义(P<0.05);术后患肢功能优良率两组间比较差异无统计学意义(P>0.05)。结论超声导引下Fogarty导管取栓术与切开探查术相比,血栓定位精准,并发症发生率降低,早期临床疗效确切。

Objective To investigate the clinical effect of ultrasound-guided Fogarty catheter thrombectomy and open exploration on arterial crisis. Methods From May 2011 to January 2017,23 patients（27 vessels） had arterial crisis after replantation of the limbs. Among them,9 patients（12 vessels） received ultrasound-guided Fogarty catheter thrombectomy（Fogarty surgery group） and 14 cases（15 vessels） underwent open exploration（incision group）. Perioperative indicators and results of postoperative 12-month follow-up were compared between the two groups. Results The mean intraoperative blood loss was significantly different between the two groups（ P〈0. 05）. There was significant difference between the two groups in the total operation time（ P〈0. 05）. There was significant difference between the two groups in postoperative amputation rate（ P〈0. 05）. There was no significant difference between the two groups in postoperative functional elite rate（P〉0. 05）. Conclusions Compared with open exploration,ultrasound-guided Fogarty catheter thrombectomy has the advantages of accurate localization of thrombosis,low incidence of complications,and early clinical efficacy.