目的 探讨介入技术结合改进的下肢动脉取栓术治疗下肢急性动脉栓塞的效果.方法 对我院2006年8月～2010年6月应用介入技术治疗的急性下肢动脉栓塞49例的临床资料进行回顾性分析.结果 本组单纯置管溶栓12例,术后再栓塞率16.67%(2/12),截肢率8.33%(1/12);单纯导管取栓19例,术后再栓塞率21.05%(4/19),无截肢患者;单纯X线引导双腔导管取栓5例,包括心脏瓣膜置换3例,动脉粥样硬化2例,全部治愈;行X线引导双腔导管取栓+斑块剥脱4例,全部治愈;行X线引导双腔导管取栓+血管腔内成形术(PTA)治疗9例,全部治愈.本组再栓塞率为12.24%,截肢率为2.04%,介入技术联合手术治疗13例,无术后再栓塞和截肢患者,无死亡病例.结论 介入技术结合传统手术治疗下肢急性动脉栓塞成功率高,且可明显降低术后再栓塞率、截肢率及病死率.%Objective To investigate the effect of intervention technology combined with improved traditional surgical thrombectomy in treatment of acute lower extremity embolic arterial occlusion.Methods The clinical data of 49 acute lower extremity embolic arterial occlusion patients who underwent intervention techniques (plaque endarterectomy, PTA, stent implant for support, etc) during August 2006 and June 2010 were analyzed.Results 12 patients were only treated by catheterdirected thrombolysis, with a postoperative embolism relapse rate of 16.67％ (2/12), amputation rate of 8.33％ (1/12); 19 were treated by catheter thrombectomy, with a postoperative embolism rate of 21.05％ (4/19), but no patient was amputated.Thrombectomy was implemented with X-ray guide double cavity catheter in 5 patients, including 3 with heart valve replacement, 2 with atherosclerosis, and all the patients were cured.4 underwent thrombectomy by X-ray guide double cavity catheter and plaque endarterectomy, and all were cured; 9 treated with thrombetomy by X-ray guide double cavity catheter and PTA were all cured, with a postoperative embolism rate of 12.24％ and amputation rate of 2.04％.13 patients received interventional techniques combined with traditional operation, with no embolism, amputation and mortality.Conclusion Interventional techniques combined with traditional operation in treatment of acute lower extremity embolic arterial occlusion patients can improve success rate, and reduce the rates of postoperative embolism relapse, amputation, and mortality.
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