CAJ | 학술논문

目的探讨手术联合介入治疗急性下肢缺血的临床疗效.方法回顾性分析2007年7月至2010年1月收治的42例急性下肢缺血患者的临床资料.所有患者术前均存在下肢急性缺血的症状,表现为疼痛、麻木、无脉、皮肤苍白、感觉异常等,均行彩超、MRI、CT诊断明确.在导管室行Fogarty导管取栓,术毕均行动脉造影检查,对血管狭窄程度＞50％者行介入治疗(包括接触性导管溶栓术、球囊扩张成形术及支架植入术).结果 42例急性下肢缺血患者无一例死亡.其中救肢成功40例,2例行截肢术,截肢平面均为膝下,截肢率4.76％.33例术后扪及足背及胫后动脉搏动,缺血症状明显改善.7例术后仍存在不同程度的缺血症状,表现为下肢疼痛、麻木等.结论在导管室行手术取栓联合介入治疗急性下肢缺血是一种安全、有效的治疗方法,并能提高救肢率及远期通畅率.手术效果取决于肢体缺血时间和程度,以及对并发症的及时处理.
목적 탐토수술연합개입치료급성하지결혈적림상료효.방법 회고성분석2007년7월지2010년1월수치적42례급성하지결혈환자적림상자료.소유환자술전균존재하지급성결혈적증상,표현위동통、마목、무맥、피부창백、감각이상등,균행채초、MRI、CT진단명학.재도관실행Fogarty도관취전,술필균행동맥조영검사,대혈관협착정도＞50％자행개입치료(포괄접촉성도관용전술、구낭확장성형술급지가식입술).결과 42례급성하지결혈환자무일례사망.기중구지성공40례,2례행절지술,절지평면균위슬하,절지솔4.76％.33례술후문급족배급경후동맥박동,결혈증상명현개선.7례술후잉존재불동정도적결혈증상,표현위하지동통、마목등.결론 재도관실행수술취전연합개입치료급성하지결혈시일충안전、유효적치료방법,병능제고구지솔급원기통창솔.수술효과취결우지체결혈시간화정도,이급대병발증적급시처리.
Objective To evaluate a combination of interventional treatment and surgical exploration for acute lower limb ischemic disease.Methods We reviewed 42 cases admitted from July 2007 to January 2010,all patients complained pain,paralysis,pulselessness,pallor and paresthesia.After Fogarty thrombectomy angiography was taken in DSA room.Patients with angiostenosis greater than 50％ were then managed by interventional treatment(CDT,PTA,Stenting).Results Lives were saved in all patients,40 lower limbs were saved,and 2 patients received below knee amputation.The amputation rate was 4.76％.Dorsal or(and)posterior tibial artery of foot was felt in 33 patients,symptoms significantly improved.The other 7 patients still had painful and paralysis on the diseased limb.Conclusions The interventional treatment and surgical operation in acute lower limb ischemic disease is safe and result is satisfactory,which can improve the long-term patency and salvage rate of the lower limb.