急性下肢动脉闭塞的临床治疗策略.docVIP

精品论文 参考文献 急性下肢动脉闭塞的临床治疗策略 黄金旗　张庆贤　郑景达　陈煌　许兴杰 福建省莆田市第一医院介入血管外科　福建　莆田　３５１１００ 作者简介:黄金旗、男、１９７７年０６年１０月出生,福建省莆田市人,汉族.１９９８年毕业于福建医科大学,医学影像与临床双学历.莆田市第一医院介入血管外科主任.擅长主动脉夹层、胸腹主动脉瘤腔内隔绝术;糖尿病足、下肢动脉硬化性闭塞腔内成形;颈动脉、肾动脉狭窄闭塞的腔内治疗;下肢深静脉血栓介入治疗;肝癌、肝血管瘤、子宫肌瘤的介入微创治疗;消化道、呼吸道、泌尿系及外伤性大出血的血管栓塞术;胆道恶性梗阻PTCD及胆道支架成形术;全身各部位肿瘤经皮穿刺射频消融术及放射性粒子置入术等. 　　【摘要】　目的　探讨不同病因诱导急性下肢动脉闭塞性病变联合治疗的临床疗效及应用价值.方法　２０１２年０３月—２０１５年０５月共收治３２例急性下肢动脉闭塞性病变患者接受治疗,所有患者发病时间均在７２小时以内.结果　５例外伤性下肢动脉闭塞患者１例接受外科旁路移植手术治疗,３例腔内支架成形术后再通,１例合并血管破裂术中植入了VHBAN 支架.３例医源性下肢动脉闭塞患者行血管内支架成形术全部再通.２４例非外因导致下肢动脉闭塞病变患者行腔内溶栓、碎栓、取栓或腔内球囊扩张成形、支架成形或切开使用Fogarty导管取栓术治疗后,完全再通１８例,降低截肢平面１例,未开通截肢２例,拒绝截肢自动出院３例.结论　多种技术联合治疗灵活应用于急性下肢动脉闭塞性疾病是一种安全有效的治疗方法,显著提高了急性下肢动脉闭塞性疾病的再通比率.【关键词】　急性下肢动脉闭塞;多种技术联合治疗;外科旁路移植;溶栓碎栓取栓;腔内成形术Theclinicaltreatingstrategiesoftheacutearterialocclusivediseaseoflowerlimbs　HuangjinqiZhangqinxiangZhenjindaChenghuangXuxingjie【Abstract】ObjectiveTostudytheclinicaleffectandapplicationsofthecombinationtherapyofacutearterialocclusivediseaseoflowerlimbswithdifferentauＧses??MethodsTheclinicaldatasof３２casesofacutearterialocclusivediseaseoflowerlimbstreatedfrom March２０１２toMay２０１５wereanalyzedretrospectively?? 　　Allofthemoccuredwithin７２hours??ResultsAmong５caseswithacutetraumaticarterialocclusionoflowerlimbs,１casewastreatedwithbypassgraftingsurgery,３caseshadrecanalizationafterintraluminalstenting,１casehadimplanttheWHBANscaffoldbecauseofhemalburs??３caseswithacuteiatrogenicarterialoccluＧsionoflowerlimbshadrecanalizationafterintraluminalstenting??Amongother２４caseswithnon－traumaticarterialocclusionoflowerlimbstreatedwithinterＧventionalthrombolysis,balloonangioplasty,coronarystentingorembolectomybyFogartycatheter,１８caseshadrecanalization,１casehadpartialrecanalization,２casesdidnothaverecanalizationbuthadamputation,and３casesdischargedvoluntarilybutrefusedamputation??ConclusionThecombinationtherapyisaneffectiveandsafemethodforthetreatmentoftheacutearterialocclusivediseaseoflowerlimbs,andwhichcansignificantlyimproverecanalizationrateoflowerextremityarteri【eKs??eywords】Acutearte