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急性腹主动脉骑跨栓塞的治疗

周宁   

  1. 天津市人民医院
  • 收稿日期:2010-08-25 修回日期:2010-12-20 出版日期:2011-05-15 发布日期:2011-05-15
  • 通讯作者: 周宁

Treatment of Acute Abdominal Arota Saddle Embolism

  • Received:2010-08-25 Revised:2010-12-20 Published:2011-05-15 Online:2011-05-15

摘要: 目的 总结急性腹主动脉骑跨栓塞的诊断和治疗的经验方法。方法 通过分析我科19例患者的临床资料,探讨了急性腹主动脉骑跨栓塞应用Fogarty导管取栓手术及围手术期治疗的心得。结果 双下肢完全治愈10例,2例截去一侧下肢。术后6例患者死亡:其中2例死于高钾血症引起的心跳骤停;2例死于多器官功能不全综合征(MODS);1例死于急性心功能衰竭;1例大面积脑梗塞后继发脑疝死亡。结论 术前的充分评估、早期的取栓手术及手术后的正确治疗是降低急性腹主动脉骑跨栓塞病死率和截肢率的关键。

关键词: 腹主动脉骑跨栓塞, Forgarty导管取栓术, 肌病肾病代谢综合征

Abstract: Objective To summarize our experience in diagnosis and treatments of abdominal aorta saddle embolism (ASE). Method we analysised the clinical datas of the 19 patients and explored the Fogarty catheter thrombolectomy and the perioprative treatments. Results Ten patients were completely cured and two patients received amputations of one limb. Six patients died in the postoperative stage, of two died of sudden cardiac asystole; two died of multiple organ dysfunction syndrome (MODS); one died of acute heart failure; and one died of hernia secondary from sever infarction. Conclusion The key points for reducing mortality and amputative rate of ASE are the sufficient evaluation of preoperative, early thrombolectomy and accurate curing of postoperative.

Key words: abdominal aorta saddle embolism, femoral Fogarty catheter thrombolectomy, myonephropathic-metabolic syndrome