介入治疗在四肢严重冻结性冷伤的临床应用效果及安全性观察

Clinical Application Effect and Safety Observation of Interventional Therapy in Severe Frozen Cold Injury of Extremities

目的:探究经导管介入性动脉内溶栓治疗四肢重度冻结性冷伤的疗效及安全性。方法:选取哈尔滨市第五医院住院治疗的45例四肢重度冻结性冷伤患者作为研究对象,按照治疗手段的不同分为介入组22例和常规组23例。其中常规组采用快速复温治疗,介入组在常规组的基础上联合经导管动脉灌注溶栓剂溶栓治疗。对比两组患者介入治疗有效性、并发症及愈合时间和截肢率情况。结果:介入组血管造影疗效优于常规组,差异有统计学意义(χ^(2)=4.896,P<0.05);采取相应干预措施后,介入组愈合时间及截肢率均低于常规组,差异有统计学意义(t=5.543;χ^(2)=4.811,P<0.05);治疗后,介入组出血发生率高于常规组,差异有统计学意义(χ^(2)=5.626,P<0.05)。结论:经导管导管动脉灌注溶栓剂治疗四肢严重冻结性冷伤疗效突出,能够促进冻结性冷伤的创面愈合并减少截肢情况发生。

Objective:To investigate the efficacy and safety of transcatheter interventional intra-arterial thrombolysis for the treatment of severe freezing cold injury of the extremities.Methods:45 cases of patients with severe freezing cold injuries of the extremities hospitalized in the hospital were selected as the study subjects,and they were divided into 22 cases in the interven-tion group and 23 cases in the conventional group according to the different means of treatment.The conventional group was treat-ed with rapid rewarming,and the intervention group was combined with transcatheter arterial infusion thrombolytic agent thrombo-lytic treatment on the basis of the conventional group.The effectiveness of interventional therapy,complications and healing time and amputation rate were compared between the two groups.Results:The angiographic efficacy of the intervention group was bet-ter than that of the conventional group,and the difference was statistically significant(χ^(2)=4.896,P<0.05).After taking appropriate interventions,the healing time and amputation rate of the intervention group were lower than those of the conventional group,and the difference was statistically significant(t=5.543;χ^(2)=4.811,P<0.05).After treatment,the incidence of thrombolytic complica-tions was higher in the interventional group than in the conventional group in terms of the incidence of bleeding,and the difference was statistically significant(χ^(2)=5.626,P<0.05).Conclusion:Transcatheter catheter arterial infusion of thrombolytic agents for the treatment of severe freezing cold injuries of the extremities has shown outstanding efficacy in promoting healing and minimizing am-putations in freezing cold injuries.