目的 探讨急诊介入治疗心房纤颤并发急性下肢动脉栓塞的方法与疗效.方法 心房纤颤并发的急性下肢动脉栓塞患者82例,其中右股动脉栓塞20例,右腘动脉栓塞及腘以下动脉栓塞14例,左髂动脉栓塞4例,左股动脉栓塞27例,左腘及腘以下动脉栓塞17例.急诊采用留置溶栓导管局部溶栓的介入方法治疗.结果 82例患者中44例(53.7%)患者经急诊介入溶栓后栓塞血管完全再通,临床症状消失;29例(35.4%)栓塞血管部分再通,临床症状明显缓解,肢体得以保存,但病程后期及随访有肢体慢性缺血的症状;7例(8.3%)因肢体缺血时间过长发生不可逆性坏死而行截肢术;2例(2.4%)患者因坏死肢体毒素的吸收,终因并发急性肾衰竭及多脏器功能衰竭而死亡.急诊介入治疗总有效率为89.1%,而截肢率和死亡率较低.结论 急诊介入留置溶栓导管方法治疗心房纤颤并发的下肢动脉栓塞,临床效果良好,截肢率低.%Objective To study the methods and effects of immediate interventional treatment for the patients with acute lower limb arterial embolism induced by atrial fibrillation( AF) . Methods 82 patients had acute lower limb arterial embolism induced by AF, including 20 cases in the right femoral artery , 14 cases in the right popliteal and sub - popliteal artery,4 cases in the left iliac artery,27 cases in the left femoral artery , 17 cases in the left popliteal and sub - popliteal artery. Interventional therapy by inlying thrombolytic catheter local thrombolysis was applied immediately. Results Complete recanalization was successful in 44 of 82 cases ( 53.7％ ) treated with the above - mentioned method and clinical symptoms disappeared completely; Partial recanalization was successful in 29 cases( 35.4％ ) ,and ischemia limb were saved in spite of chronic limb ischemia occurred in the follow - up.7 cases ( 8.3％ ) were amputated as a result of irreversible limbs necrosis. 2 cases (2.4％ ) died from acute renal failure and MODS resulting from absorption of toxins in the putrid limbs. Conclusion Immediate interventional therapy by implanting thrombolytic catheter is a safe and effective method with lower amputation rate for acute limh embolism in the patients induced by AF.
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