腹主动脉骑跨栓塞15例的临床救治分析

目的:总结腹主动脉骑跨栓塞的救治经验和教训.方法:回顾性分析了我院采用双股动脉Fogarty导管取栓治疗腹主动脉骑跨栓塞15例.结果:血流再通后早发死亡3例,主要原因为高血钾引起的心搏骤停;迟发死亡4例,主要原因为急性肾功能衰竭(ARF)为首发的多器官功能不全综合征(MODS).存活8例,有5例截去单侧或双侧下肢.远期随访5例,存活肢体血运良好.结论:早期诊断,早期取栓治疗是降低腹主动脉骑跨栓塞病死率和截肢率的关键.术中预防高钾血症引起的心搏骤停、术后及早防治ARF阻断其病理连锁反应,预防MODS发生是降低死亡率的重要环节.

Treatment of abdominal aorta saddle embolism:report of 15 cases

Objective: To discuss the experiences and lessons in treating the abdominal aorta saddle embolism cases. Methods: Fifteen cases of abdominal aorta saddle embolism were treated with Forgarty catheter. Results: After the blood perfusion recovered, 3 died in the early stage because of sudden stop of heart due to hyperkalemia, and 4 died in the late stage caused by multiple organ dysfunction syndrome, which always occurred with acute renal failure first. In 8 cases alive, 5 received amputation. 5 cases were followed up, and the blood supply of the legs alive was fine. Conclusion: Early diagnosis and treatment are key points to decrease the rate of death and amputation. Prevention and therapy of hyperkalemia and acute renal failure are important for reduction of death rate.