摘要
目的分析腹股沟以下急性下肢动脉缺血介入取栓治疗的效果。方法选取2016年7月至2019年5月郑州大学第二附属医院收治的接受腹股沟以下急性下肢动脉缺血介入取栓治疗的88位患者(93例患肢)的临床资料作为研究对象。其中血流分级Ⅰ级19例(20.4%),Ⅱa级59例(63.4%),Ⅱb级15例(16.1%)。37例(39.8%)闭塞部位开始于膝关节以下,56例(60.2%)开始于膝关节以上。患者接受导管抽吸取栓,如果未能恢复理想血流,则额外接受机械血栓切除装置治疗。原则上优先选择顺行通路,如果闭塞段血管距离穿刺点过近(<10 cm),则通过对侧股动脉入路。结果93例患肢中85例(91.4%)取得技术上的成功。90例(96.8%)通过常规导管抽吸取栓。33例(35.5%)通过机械血栓切除装置取栓。88例(94.5%)患肢的临床症状有所改善。9例(9.6%)患肢出现远端异位栓塞,此为主要并发症;5例(5.3%)被不同程度截肢;1位患者在早期随访中死亡。结论介入取栓术是治疗腹股沟以下急性下肢动脉缺血的有效方法。
Objective To analyze the effect of interventional embolization for acute lower extremity artery ischemia under groin.Methods The clinical data of 88 patients(93 limbs)who accepted interventional thrombotherapy of acute lower extremity artery ischemia under the groin were selected from July 2016 to May 2019 in the Second Affiliated Hospital of Zhengzhou University.There were 19 patients(20.4%)had gradeⅠblood flow classification,and there were 59 cases(63.4%)of classⅡA and 15(16.1%)of gradeⅡB.There were 37 cases(39.8%)began to block the area below the knee joint,and 56 cases(60.2%)began above the knee joint.If the patient failed to recover the ideal blood flow,he was additionally treated with mechanical thrombectomy device.In principle,antegrade access should be preferred.If the occluded artery was too close to the puncture point(<10 cm),the contralateral femoral artery approach should be adopted.Results Of the 93 patients,85(91.4%)were technically successful.Ninety cases(96.8%)were aspirated by conventional catheter.Thirty-three cases(35.5%)were embolected by mechanical thrombectomy device.The clinical symptoms of 88 cases(94.5%)were improved.Nine cases(9.6%)had distal ectopic embolism,which was the main complication;five cases(5.3%)were amputated;one patient died during early follow up.Conclusion Interventional thrombectomy is an effective method for the treatment of acute lower extremity arterial ischemia below inguinal region.
作者
林亚超
冯广森
许立国
余海彬
LIN Yachao;FENG Guangsen;XU Liguo;YU Haibin(Department of Intervention,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China;Department of Cardiovascular Surgery,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)
出处
《河南医学研究》
CAS
2021年第14期2518-2521,共4页
Henan Medical Research
关键词
急性下肢动脉缺血
介入取栓
机械血栓切除
acute lower extremity arterial ischemia
interventional embolectomy
mechanical thrombectomy
