下肢缺血性疾病228例治疗分析

发布时间：2018-04-02 08:45

本文选题：动脉缺血　切入点：置管溶栓　出处：《中华全科医学》2016年10期

【摘要】：目的探讨下肢动脉缺血性疾病的临床发病情况及治疗措施。方法回顾性分析血管外科2014年1月—2015年7月期间共收治228例下肢动脉缺血性疾病患者的临床资料,治疗上根据疾病缓急、病变部位及特点选择个体化治疗方案,包括药物治疗,股、乆动脉切开Fogarty球囊导管取栓术,股、乆动脉顺行置管溶栓术,病变段动脉球囊扩张或支架植入术,取自体大隐静脉或人工血管行动脉旁路移植术,截肢术,多种治疗手段相结合的复合式手术等。结果急性下肢动脉缺血患者共87例,急性下肢动脉栓塞患者48例,急性下肢动脉血栓形成患者39例,经治疗有效79例(90.8%),无效8例(9.2%),截肢7例(8.0%),死亡1例(1.2%);慢性下肢动脉缺血患者共141例,下肢动脉硬化闭塞症患者105例,下肢血栓闭塞性脉管炎患者36例,经治疗有效127例(90.1%),无效14例(9.9%),截肢12例(8.5%),死亡2例(1.4%)。结论下肢动脉缺血性疾病的发病率越来越高,若治疗不及时致残、致死率较高,治疗下肢缺血性疾病,为了降低致残、致死率,应根据疾病缓急、病变部位及特点结合患者自身状况综合考虑选择药物、腔内成形、开放手术或多种治疗手段相结合的治疗方式。
[Abstract]:Objective to investigate the clinical incidence and treatment of lower extremity arterial ischemic disease. Methods the clinical data of 228 patients with lower extremity arterial ischemic disease treated in vascular surgery from January 2014 to July 2015 were retrospectively analyzed. According to the priority of the disease, the location and characteristics of the disease, the individual treatment plan was selected in the treatment, including drug treatment, femoral, Fogarty balloon catheter thrombectomy, femoral embolization and thrombolysis. Balloon dilatation of diseased segmental artery or stent implantation were performed from saphenous vein or artificial blood vessel for arterial bypass grafting, amputation, and combined operation of multiple treatment methods. Results 87 patients with acute lower extremity artery ischemia were involved. There were 48 patients with acute arterial embolism of lower extremity, 39 patients with acute arterial thrombosis of lower extremity, 79 patients with acute arterial thrombosis of lower extremity, 79 patients with effective treatment, 9. 8patients who had no effect, 8 patients with amputation, 7 patients with amputation and 1 patient who died. There were 141 patients with chronic arterial ischemia of lower extremity. There were 105 patients with arteriosclerosis obliterans of lower extremity and 36 patients with thromboangitis obliterans of lower extremities. There were 127 cases of effective treatment, 14 cases of ineffectiveness, 14 cases of amputation, 12 cases of amputation, 2 cases of death, and 2 cases of death. Conclusion the incidence of lower extremity arterial ischemic diseases is increasing. In order to reduce the morbidity and mortality of patients with ischemic diseases of lower extremities, we should consider the choice of drugs according to the priority of disease, the location and characteristics of disease, and the condition of patients. Open surgery or a combination of multiple treatments.
【作者单位】：蚌埠医学院第一附属医院血管外科;
【基金】：2016年度安徽高校自然科学研究项目(KJ2016-SD38)
【分类号】：R654.4

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