急性下肢缺血94例诊治分析

Diagnosis and treatment of 94 cases with acute lower limb ischemia

目的探讨动脉取栓术及导管溶栓术治疗不同类型急性下肢缺血(acute limb ischemia,ALI)效果的差异。方法回顾性分析海南省人民医院2012年1月至2018年1月入院的94例ALI患者,依据病因分为急性动脉栓塞(acute arterial embolization,AAE)组(62例)和急性动脉血栓形成(acute arterial thrombosis,AAT)组(32例),分析两组临床资料并比较动脉取栓术及导管溶栓术的治疗效果。结果AAT组有17例患者在接受取栓或溶栓治疗外接受了动脉再通或重建手术。两组患者行动脉取栓术治疗的效果相当。然而,导管溶栓术在AAT组的治疗有效率及踝肱指数的改善程度方面低于AAE组。结论AAT和AAE在不同的治疗方式上效果存在差异,应重视ALI的病因筛查并选择合适的治疗方式。

Objective To investigate the differences in the effects of arterial thrombectomy and catheter thrombolysis for different types of acute lower limb ischemia(ALI).Methods The clinical data of 94 ALI patients admitted to Hainan People's Hospital from January 2012 to January 2018 were analyzed retrospectively.According to the etiology,the patients were divided into acute arterial embolization(AAE)group(62 cases)and acute arterial thrombosis(AAT)group(32 cases).The clinical data of the two groups were analyzed and the therapeutic effects of arterial thrombectomy and catheter thrombolysis were compared.Results Seventeen patients in the AAT group underwent arterial recanalization or reconstructive surgery received thrombectomy or thrombolysis additionally.The effect of arterial thrombectomy in both groups was similar.However,catheter thrombolysis was lower in the AAT group than in the AAE group in terms of treatment effectiveness and improvement of ankle brachial index.Conclusion There is a difference in the effects of AAT and AAE on different treatment methods.It is necessary to pay attention to the screening of ALI and select the appropriate treatment.