留置溶栓导管介入治疗急性下肢动脉血栓栓塞的临床研究

目的 探讨急性下肢动脉血栓栓塞患者留置溶栓导管介入治疗的方法与疗效.方法 112例急性下肢动脉血栓形成或栓塞患者,其中冠心病或风湿性心脏病合并心房颤动致下肢动脉栓塞85例,各种原因导致的血栓形成27例;所有患者均采用留置溶栓导管局部持续溶栓的方法介入治疗.结果 112例患者中77例(68.8%)患者经介入留置溶栓导管溶栓后栓塞血管完全再通;23例(20.5%)患者栓塞血管部分再通,肢体得以保全,但后期随访16例患者仍有肢体慢性缺血症状;9例(8.0%)因肢体缺血时间过长,发生不可逆性坏死而行截肢术;3例(2.7%)因发生急性再灌注损伤并发急性肾衰竭或再发脑梗死而死亡.结论 留置溶栓导管介入治疗急性下肢动脉血栓栓塞安全、有效,截肢率低.

Abstract：

Objective To study the methods and effects by using thrombolytic catheter in interventional treatment for patients with acute lower limb arterial thrombosis or embolism. Methods One hundred and twelve patients suffered acute lower limb arterial thrombosis or embolism. There were 85 cases of acute lower limb arterial embolism induced by atrial fibrillation in coronary or rheumatic heart disease,other 27 cases of arterial thrombosis caused by different reasons. Interventional treatment by inlying thrombolytic catheter was applied and continuous perfusion was received locally in all patients. Results Complete recanalization was got in 77 cases (68.8%) of 112 cases. Partial re canalization was got in 23 cases (20.5%), and ischemia limbs were saved in spite of chronic limb ischemia(chronic spasmodic limb) occurring in the later follow-up. Nine cases (8.0%) were amputated as a result of irreversible limbs necrosis, 3 cases (2.7%) died from acute renal failure resulting from reperfusion injury or recurrent cerebral embolism.Conclusion Interventional treatment by inlying thrombolytic catheter is a safe and effective method with lower amputation rate for acute lower limb arterial thrombosis or embolism in patients.

Clinical research of interventional treatment by inlying thrombolytic catheter for patients with acute lower limb arterial thrombosis or embolism

Objective To study the methods and effects by using thrombolytic catheter in interventional treatment for patients with acute lower limb arterial thrombosis or embolism. Methods One hundred and twelve patients suffered acute lower limb arterial thrombosis or embolism. There were 85 cases of acute lower limb arterial embolism induced by atrial fibrillation in coronary or rheumatic heart disease,other 27 cases of arterial thrombosis caused by different reasons. Interventional treatment by inlying thrombolytic catheter was applied and continuous perfusion was received locally in all patients. Results Complete recanalization was got in 77 cases (68.8%) of 112 cases. Partial re canalization was got in 23 cases (20.5%), and ischemia limbs were saved in spite of chronic limb ischemia(chronic spasmodic limb) occurring in the later follow-up. Nine cases (8.0%) were amputated as a result of irreversible limbs necrosis, 3 cases (2.7%) died from acute renal failure resulting from reperfusion injury or recurrent cerebral embolism.Conclusion Interventional treatment by inlying thrombolytic catheter is a safe and effective method with lower amputation rate for acute lower limb arterial thrombosis or embolism in patients.