CAJ | 학술논문

目的总结肢体动脉栓塞病例的治疗效果,探讨影响疗效的主要因素以提高疗效.方法对1984年12月至2006年12月收治的536例次动脉栓塞病例的病因、治疗、预后及随访结果进行回顾性分析.急诊或限期的Fogarty取栓导管动脉取栓术507例次,二次手术34例次.保守治疗29例次.结果痊愈率76.68%;死亡率9.51%;截肢率10.26%.复发率为11.7%.心肺功能衰竭(27.45%)、肾功能衰竭(25.49%)等是围手术期主要致死原因.出院后正规服用华法令并监测的221例房颤患者,均无明显出血倾向及严重并发症.25.6%的患者同次住院期间或出院后1年内接受了心脏换瓣等手术治疗.结论动脉栓塞对肢体和生命均构成威胁,治疗应足综合性的;缺血时间、程度、缺血.再灌注损伤是影响疗效的主要因素;对明确心源性栓子来源合并房颤者,须重视抗凝及病因学治疗.
목적 총결지체동맥전새병례적치료효과,탐토영향료효적주요인소이제고료효.방법 대1984년12월지2006년12월수치적536례차동맥전새병례적병인、치료、예후급수방결과진행회고성분석.급진혹한기적Fogarty취전도관동맥취전술507례차,이차수술34례차.보수치료29례차.결과 전유솔76.68%;사망솔9.51%;절지솔10.26%.복발솔위11.7%.심폐공능쇠갈(27.45%)、신공능쇠갈(25.49%)등시위수술기주요치사원인.출원후정규복용화법령병감측적221례방전환자,균무명현출혈경향급엄중병발증.25.6%적환자동차주원기간혹출원후1년내접수료심장환판등수술치료.결론 동맥전새대지체화생명균구성위협,치료응족종합성적;결혈시간、정도、결혈.재관주손상시영향료효적주요인소;대명학심원성전자래원합병방전자,수중시항응급병인학치료.
Objective To evaluate the treatment for acute embolism in the extremities and define the primary factors affecting the prognosis. Methods From December 1984 to December 2006,536 patients with acute embolism of extremities were treated. Embolectomy with Forgarty catheters were performed in 507 cases, including salvage surgery in 34 cases and conservative therapy in 29 cases. Results The cure rate, mortality and amputation rate were 76.68%,9.51% and 10.26% respectively. Embolism recurred in 11.7% cases. Cardiopulmonary (27.5% ) and renal failure ( 25.5% ) were main causes of death during perioperative period. No bleeding nor other major complications occurred in 221 patients with atrial fibrillation who routinely received wafarine under proper monitoring. About 25.6% patients underwent heart valves surgery during hospitalization or within one year after discharge. Conclusions Patients suffering from acute embolism of the extremities should receive combination treatment. The main factors affecting the prognosis include time and degree of ischemia, and ischemia-reperfusion injury. Anticoagulant and etiologic treatment should be adopted in those with cardiogenic embolus and atrial fibrillation.