目的 对比DSA监视下Forgarty导管取栓术和大腔导管血栓抽吸术治疗急性下肢动脉栓塞的临床疗效.方法 回顾性分析56例急性下肢动脉栓塞患者,26例接受DSA监视下Forgarty导管取栓术(Forgarty导管组),30例接受大腔导管血栓抽吸术(大腔导管抽吸组),术后接受抗凝、溶栓等综合治疗.分析两组患者术前、术后即刻和综合治疗后患肢踝肱指数(ABI)的变化和两种治疗方法去除栓塞物的效能.结果 56例患者患肢均恢复血流,保肢率98.21％ (55/56),围术期无死亡.Forgarty导管组术后即刻ABI大于大腔导管抽吸组(P＜0.001),综合治疗后,二者ABI差异无统计学意义.两组栓塞物总完全清除率和总部分清除率分别为96.15％(25/26)、3.85％(1/26)和70.00％(21/30)、30.00％ (9/30).结论 采用Forgarty导管取栓术治疗急性下肢动脉栓塞优于大腔导管血栓抽吸术；经抗凝、溶栓等综合治疗后,二者临床结果相似.%Objective To compare the clinical embolus removing efficiency between Forgarty catheter embolectomy and percutaneous aspiration embolectomy (PAE) through large-lumen catheter monitored by DSA in the treatment of acute lower extremity artery embolism. Methods Fifty-six patients with acute lower extremity artery embolism were collected. Twenty-six cases were treated with Forgarty catheter embolectomy monitoring by DSA (Forgarty catheter group). The other 30 eases underwent PAE (large-lumen catheter group). Anticoagulation and thrombolytic treatment were performed postoperatively. The preoperative, instant postoperation and after comprehensive treatment ankle brachial index (ABI) were analyzed, as well as the efficiency of removing embolus in the two groups. Results Blood flow reverted successfully in all cases, the limb salvage rate was 98. 21 % (55/56), no death occurred during perioperational stage. The postoperative instant ABI of Forgarty catheter group was higher than that of large-lumen catheter group (P<0. 001), and the ABT after comprehensive treatment of two groups were not statistically different The embolus total complete clearance rate and total part clearance rate in two groups was 96.15% (25/26), 3. 85% (1/26); 70. 00% (21/30), 30. 00% (9/30), respectively. Conclusion The efficiency of removing embolism with Forgarty catheter is better than that of PAE in the treatment of acute lower extremity artery embolism, while the clinical result is similar after comprehensive treatment with anticoagulation and urokinase thrombolysis.
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