下肢动脉缺血性疾病介入术后再闭塞的导管接触性溶栓治疗

Catheter-directed thrombolysis treatment for re-occlusion after interventional therapy for lowerlimb ischemic diseases

目的评价导管接触性溶栓在下肢动脉缺血患者介入术后再闭塞的治疗效果。方法 2013年1月至2015年10月对32例下肢动脉缺血介入术后再闭塞患者,采用溶栓导管动脉内接触性溶栓治疗,部分病例联合球囊扩张及支架成形术,观察患肢血管通畅程度及血运情况,统计治疗前后患肢踝肱指数,并进行统计学比较。结果本组溶栓总有效率达93.8%,治疗后皮肤温度回升,静息痛消失,踝肱指数由术前的0.15±0.06升高至0.81±0.05,治疗前后比较差异有统计学意义(P<0.01)。结论动脉内溶栓导管接触性溶栓,能够溶解大部分血栓,治疗后复通率高,可显著提高保肢率,是介入治疗术后再闭塞的首选治疗方法。

Objective To evaluate the efficacy of catheter-directed thrombolysis treatment for reocclusion after interventional therapy for lower limb ischemic diseases.Methods From January2013to Oct2015,catheter-directed thrombolysis combined with angioplasty was selectively performed in32re-occlusion cases after interventional therapy for lower limb ischemic diseases.The efficacy of thrombolysis and recanalization of the artery were observed.Results The total successful rate of thrombolysis was93.8%.After treatment,the skin temperature improved and rest pain disappeared without symptom of garbage feet.The ankle-brachial index(ABI)increased from(0.15±0.06)preoperatively to(0.81±0.05)postoperatively,the difference was statistically signifi cant(P<0.01).Conclusions Catheter-directed thrombolysis is capable to dissolve most of the thrombus so it can incresae the recanalization rate and the rate of limb salvage remarkably.Catheter-directed thrombolysis is the fi rst choice for re-occlusion after interventional therapy for lower limb ischemic diseases.