急性下肢动脉重症缺血的疗效分析

目的 探讨急性下肢动脉重症缺血的临床治疗效果.方法 收集2014年1月-2016年7月就诊于上海交通大学医学院附属仁济医院急性下肢动脉重症缺血的病例共39例,依据患者病情分别进行了切开取栓或溶栓或吸栓或球囊扩张或支架置入等腔内治疗,观察其临床治疗效果和并发症.结果 39例患者中,发生死亡18例(18/39,46.2％),其中未手术患者5例,手术患者13例.34例手术者中,行大腿截肢术8例.顺利出院者21例中,失访2例,随访3 ～ 27个月,平均14.3个月.其中死于心脑血管或肿瘤疾病5例,有足下垂表现3例,行足趾小截趾2例,足部或小腿远端感觉缺失3例.结论 尽早采取适当治疗方法,并加强多脏器功能的管理,才能提高急性下肢动脉重症缺血的疗效.

Clinical effect analysis in the treatment of acute limb arterial critical ischemia

Objective To discuss the therapeutic effect in the treatment of the acute limb arterial critical ischemia.Methods Collect thirty-nine cases of acute limb arterial critical ischemia in Renji Hospital from Janary 2014 to July 2016.According to the patients' manifestation,these operations were porfermed including thrombectomy,cathetery-directed thrombolysis,mechanical suction bolt,percutaneous angioplasty and stenting.The effect and complications were observed.Results The eighteen patients in 39 cases (46.2％) were dead,including 5 cases without operation,13 operation.The eight cases were amputated during 34 cases of operations.In the 21 out-patients safely,2 cases were not followed up.The time of follow-up was from 3 to 27 months,on average 14.3 months.During the 21 patients,5 cases died from heart cerebrovascular or tumor diseases,3 cases with footdrop,2 cases with toe amputations,3 cases with distal leg and foot anesthesias.Conclusions The patiens with acute limb arteries critical ischemia must be treated as early as,and reinforced the management of multiple organ function,which may improve the diseases' therapeutic effect.