急性肢体缺血的治疗

目的 探讨急性肢体缺血的治疗方法 .方法 回顾性分析28例急性肢体缺血的临床资料.4例急性动脉栓塞者行急症取栓术,1例假性动脉瘤患者行假性动脉瘤切除及人工血管植入术,23例动脉闭塞症者采用取栓、血管旁路术、血管腔内治疗、截肢、单纯药物等治疗.结果 5例急性动脉栓塞及假性动脉瘤患者治疗成功,23例动脉闭塞症患者中,5例(21.7%)治疗成功,12例(52.2%)好转,6例(26.1%)无效,4例截肢(占动脉闭塞疾病的17.4%).无1例死亡.6～45个月随访中,另有5例截肢,死亡4例.结论 急性肢体缺血患者需根据病情选择合理的治疗策略,包括取栓及血管重建等,以达到挽救肢体和生命的目的 .

Treatment of acute limb ischemia

Objective:To investigate the management of acute limb ischemia.
Methods:The clinical data of 28 patients with acute limb ischemia were retrospectively analyzed. Four patients with arterial embolism underwent embolectomy. one patient with pseudoaneurysm underwent false aneurysm resection and revascularization with PTFE, 23 patieuts wiht arterial occlusive disease were treated by multiple means such as embolectomy，bypass,primary amputation, endovascular interventions，and pharmacologic therapy (n=23).
Results:The 5 patients with arterial embolism or pseudoaneurysm were all treated successfully.In the 23 patients with arterial occlusive disease, 5(21.7%) were  treated successfully, 12(52.2%) were improved,and 6(26.1%) had ineffective treatment. No inpatient died, but 4 patients underwent amputation.During follow-up of 6-45 months，there were 4 deaths and other 5 amputations.
Conclusions:Proper intervention of patients with acute limb ischemia should be chosen according to clinical evaluation of the illness,and includes embolectomy and revascularization, to get limb or life salvage.