Fogarty导管取栓治疗肢体动脉栓塞疗效分析

目的 探讨各种因素对肢体动脉栓塞疗效的综合影响.方法 回顾分析用Fogarty导管取栓共救治 21例(23条)急性肢体动脉栓塞病例.结果 1例高龄病例因术前合并慢性支气管炎肺心病并感染,取栓术后截肢,后死于肾功能衰竭;其余病例经积极救治均保全了肢体和生命,2例术后早期出现骨筋膜室综合征再行减压术,保肢成功.结论 彩色多普勒超声检查有助于疑诊病例的确诊,术前肢体的缺血时间、缺血程度、术中血栓取出的彻底性和操作技巧,术中、术后针对再灌注损伤的综合性用药及对手术并发症的有效控制是取得良好疗效的关键.

Analysis on curative effect of fogarty catheter embolectomy for arterial embolism in extremity

Objective To analyze retrospectively the comprehensive influence on the curative effect of arterial embolisms in the extremities. Methods 23 limbs in 21 cases with acute arterial embolisms in the extremities were salvaged by using Fogarty catheters. Results One venerable aged patient with chronic bronchitis and pneumocardial disease was amputated one month after embolectomy and died of kidney failure two months later. The limbs and lives of the rest were saved through active measures. Two cases who developed osseoaponeurotic compartment syndrome early postoperatively were performed fascia decompression, and the extremities were saved successfully. Conclusion Doppler scan is useful in making sure of the doubted cases with arterial embolisms in extremities. Thoroughness and skill in embolectomy, comprehensive treatment during and after operation for the reperfusion injury, and effective control of the complication are the key factors to achieve good curative effect.