天津医药

天津医药 ›› 2015, Vol. 43 ›› Issue (2): 206-208.doi: 10.11958/j.issn.0253-9896.2015.02.025

• 应用研究 • 上一篇    下一篇

急性下肢动脉缺血处理方式的比较

王峥， 赵岳△   

  1. 天津医科大学 （邮编300070）
  • 收稿日期:2014-06-04 修回日期:2014-10-28 出版日期:2015-02-15 发布日期:2015-02-27
  • 通讯作者: 赵岳 E-mail:yuezhao35@hotmail.com

Effect of different interventions on acute ischemic disease of lower extremities

  • Received:2014-06-04 Revised:2014-10-28 Published:2015-02-15 Online:2015-02-27

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摘要： 摘要： 目的 比较取栓治疗与置管溶栓治疗对急性下肢动脉缺血的治疗效果。方法 收集天津医科大学总医院 2011—2013 年经彩色多普勒和 （或） CT 血管造影检查收治的 66 例急性下肢动脉缺血患者 （发病在 3 d 内）， 根据患方意愿分别归入取栓组 （32 例） 和溶栓组 （34 例）。收集患者术后的症状缓解率、 保肢率、 病死率、 再灌注损伤发生率 （包括肾功能不全发生率、 心功能衰竭发生率、 肌筋膜室综合征发生率）、 出血率及肢体功能障碍率， 进行统计学分析。结果 取栓组与溶栓组的症状缓解率 （93.8% vs 94.1%）、 保肢率 （96.9% vs 100%）、 病死率 （3.1% vs 0）、 出血率 （0 vs 8.8%）、 患肢功能障碍率 （0 vs 5.9%） 等方面差异无统计学意义 （P＞0.05）。溶栓组再灌注损伤的发生情况显著低于取栓组 （2.9% vs 37.5%， P＜0.05）。结论 溶栓治疗对急性下肢动脉缺血的治疗效果与取栓治疗基本相同， 对患者的缺血再灌注损伤特别是肾功能损伤方面较取栓治疗明显减轻。

关键词: 动脉闭塞性疾病, 缺血, 导管介导溶栓, 取栓术, 急性下肢动脉缺血

Abstract: Abstract： Objective To compare the treatment effects of catheter directed thrombolysis and thrombetomy for acute ar⁃ terial ischemia of the lower extremity. Methods Patients who visited Tianjin Medical University General Hospital from 2011 to 2013 and were attacked by acute ischemic disease of lower extremities within 3 days (n=66) were investigated. Thrombetomy and thrombolysis treatment had been performed to 32 cases and 34 cases respectively according to patients’ own willingness. Postoperative symptom remission rate, limb salvage rate, fatality rate, reperfusion injury rate (including re⁃ nal inadequacy, heart failure, muscle fascia compartment syndrome), bleeding rate and limb dysfunction rate were compared between these two groups. Results There was no statistical difference on the rate of symptom remission（93.8% vs 94.1%） , limb salvage（96.9% vs 100%） , case fatality rate （3.1% vs 0） , bleeding rate（0 vs 8.8%）and limb dysfunction rate （0 vs 5.9%） between these two groups. However, the incidence of reperfusion injury was higher in the group of thrombectomy （37.5% vs 2.9%, P <0.05） compared to that of the other group. Conclusion Similar effect of treatment and less reperfusion injury, especially renal injury, had been achieved by CDT compared with thrombetomy.

Key words: arterial occlusive diseases, ischemia, catheter directed thrombolysis (CDT), thrombectomy, acute ischemia of lower extremity