肢体动脉栓塞的临床分析

目的 总结肢体动脉栓塞病例的疗效,探讨影响治疗结果的主要因素,确定恰当的治疗方案.方法 作者对2001年4月至2007年4月68例动脉栓塞病例的病因、治疗及愈后情况进行回顾性总结.结果 栓子来源于风心病者占52.94%,冠心痛者占39.71%,伴有心房纤颤者占73.52%,痊愈率86.76%,死亡率5.88%,截肢率7.35%.结论 动脉栓塞患者多伴有心脏等重要脏器的器质性病变,治疗应是综合性的;缺血时间、缺血程度、缺血-再灌注损伤是影响治疗结果的主要因素;取栓术中注重Fogarty取栓导管的操作技巧,必要的手术以及术后适时的筋膜切开、药物治疗对保存肢体更为有效.

Clinical Analysis of Arterial Embolism in Extremities

Objective The purpose of this study was to summarize the curative effect of acute embolism in extremities which were accepted treatment in our unit within 6 years,consider the major factors to have influence on therapeutic results,determine right procedure of treatment.Methods During the past 6 years from April 2001 to April 2007,68 patients of acute embolism of extremities were treated in department of Surgery of our Hospital,review these cases and have a retrospective study in pathogeny,management and outcome.Results Total 52.94% embolus rooted in rheumatic heart disease,and 39.71% rooted in coronary heart disease,accompanyed with atrial fibrillation were 73.52%.The rate of cure,mortality and amputation were respectively 86.76%,5.88% and 7.35%.Conclusion The patients with acute embolism should receive combination treatment,as most of them accompanied with their heart and other important organs organically wrong.The main factors to influence the result of treatment included the time and degree of ischemia,and ischemia-reperfusion injury.Pay attention to operative skill of Fogarty ballon catheter in embolectomy,treat with complex operation in case of necessity,postoperative fasciectomy and drug management were helpful in limb survival.