论文部分内容阅读
目的探讨导管直接溶栓(catheter-directed thrombolysis,CDT)治疗急性下肢缺血(acute lower limb ischemia,ALLI)并发症的发生原因和防治措施。方法回顾性总结2012年1月至2014年1月收治的82例(82条肢体)ALLI患者中行CDT治疗的临床资料。结果本组患者均成功实施CDT治疗,术后并发症的总发生率为30.49%(25/82),其中穿刺点血肿2.44%(2/82),穿刺点假性动脉瘤1.22%(1/82),肝素诱导的血小板减少症(heparin-induced thrombocytopenia,HIT)1.22%(1/82),结膜下出血2.44%(2/82),CDT治疗中血栓脱落引起2次栓塞6.10%(5/82),溶栓导管引起的动脉穿孔1.22%(1/82),骨-筋膜室综合征15.85%(13/82)。结论术前严格掌握适应证,术中精细规范操作,术后及时发现异常并且妥善处理,可以有效减少并发症的发生率。
Objective To investigate the causes of catheter-directed thrombolysis (CDT) in the treatment of complications of acute lower limb ischemia (ALLI) and its prevention and treatment. Methods The clinical data of CDT in 82 patients (82 limbs) with ALLI admitted from January 2012 to January 2014 were retrospectively reviewed. Results The patients were successfully treated with CDT. The total incidence of postoperative complications was 30.49% (25/82), including 2.44% (2/82) of puncturing points and 1.22% of puncturing points of pseudoaneurysm (1 / 82), 1.22% (1/82) in heparin-induced thrombocytopenia (HIT), 2.44% (2/82) in subconjunctival hemorrhage, and 2.10% (5 / 82), arterial perforation caused by thrombolytic catheter 1.22% (1/82), and bone-compartment syndrome 15.85% (13/82). Conclusion Preoperative rigorous indications, intraoperative fine norms operation, abnormal and timely detection of postoperative and properly handle, can effectively reduce the incidence of complications.