患肢动脉导管溶栓治疗急性下肢动脉栓塞的临床观察

目的探讨患肢动脉导管溶栓治疗急性下肢动脉栓塞的临床观察的临床治疗效果。方法 35例急性下肢动脉栓塞患者采用患肢动脉导管注药溶栓治疗,术后继予尿激酶及低分子肝素、阿加曲班注射液等抗凝、祛聚、扩动脉药物治疗,维持6个月以上。诊治期间观察是否有出血等并发症,溶栓期间监测多项凝血相关实验室检查:国际标准化比值(INR)控制于2.0～2.5,凝血酶原时间(PT)控制于25s以内,活化部分凝血活酶时间(APTT)控制于正常值1.5～2.0倍,纤维蛋白原(FIB)控制于1.0g/L以上,必要时给予药物剂量调整。评价35例患者溶栓总治愈率。结果 22例患者在治疗后6～72h患肢血供恢复正常,治愈率62.86%。11例血供得以改善,有效率31.43%,总有效率94.29%。2例无效行截肢手术,无效率5.71%。有效11例中3例股浅动脉全程血栓,溶栓后血栓头端部分溶解,造影示小腿广泛侧支循环形成,临床症状显著减弱,缺血范畴控制;2例溶栓前已有足踝之下皮肤变黑,诊治后坏死平面减少,坏死感染转好;余6例溶栓后部分开通,3例仍有不同程度间歇性跛行,出院进一步诊治后都改善。结论患肢动脉导管注药溶栓治疗急性下肢动脉栓塞安全有效。

Clinical observation of thrombolytic therapy for acute arterial thrombosis of lower extremity

Objective To investigate effect of thrombolytic therapy for acute lower extremity arterial thrombosis.Methods Thirty five cases with acute lower extremity arterial embolism were treated by limb arterial injection of thrombolytic therapy.Then,treated with anticoagulant,platelet aggregation,arteries expanding drug for more than 6 months.Bleeding and other complications were observed,laboratory tests related to coagulation monitoring during thrombolytic therapy was done.International normalized ratio(INR) was ...