急性肢体动脉缺血再通术后再灌注损伤的治疗

Treatment of acute four-limb arterial ischaemia after tepatency operation

目的 探讨急性肢体动脉缺血再通术后再灌注损伤的有效治疗方法。方法 回顾性分析 198例急性肢体动脉缺血再通术后再灌注损伤治疗患者的临床资料 ,上肢 31例 ,下肢 16 7例。结果 198例急性肢体动脉缺血再通术后出现再灌注损伤 116例。上肢急性动脉缺血再通术后再灌注损伤程度较下肢轻 ,肢体急性动脉栓塞再通术后再灌注损伤程度较动脉硬化闭塞症继发急性血栓形成重 ,再通术后再灌注损伤程度与术前缺血时间及缺血程度成正比关系。动脉再通后 2 0min出现再灌注损伤 ,12h达到高峰 ,2 5h后开始缓解 ,时间 8～ 13d。肌筋膜切开 16例 ,死亡 5例 ,药物治愈 95例。结论 及时实施再通术是预防再灌注损伤的关键 ,再通术前后的有效治疗能够有效缓解再灌注损伤的发生。

Objective To investigate effective treatment method for acute four-limb arteral ischaemia after repateney operation .Methods Retrospective analyse was made on 198 cases with reperfusion injury treatment of the acute arterial ischaemia after repateney operation .Results Among 198 cases of the acute four-limb arteral ischaemia,16 cases needed reperfusion injury treatment after repatency operation. Injury level in upper limbs was lower than that in lower limbs.The injury level of the acute arterial embolism of the four-limb higher was than acute thrombosis.There was proportion between level and time of reperfusion injury.The reperfusion injury appeared 20 minutes after arterial repatency.It reached peak at 12 hours .It beagan relieving at 25 hours.It maintained 8-13 days. 16 cases cut open musculoaponeuratic.5 patients died.Conclusion Effective treatment can relieve reperfusion injury before and after repatency operation .Timely repatcncy operation is the key to prevent reperfusion injury.