中国实用外科杂志

中国实用外科杂志 ›› 2009, Vol. 29 ›› Issue (08): 667-668.

• 论著 • 上一篇    下一篇

急性上肢动脉栓塞诊断和外科治疗

李松奇，叶财盛，胡作军，吕伟明，李晓曦，林勇杰，王深明   

  1. 中山大学附属第一医院血管外科，广东广州510080
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2009-08-01 发布日期:2009-08-01

  • Received:1900-01-01 Revised:1900-01-01 Online:2009-08-01 Published:2009-08-01

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摘要：

目的 回顾性总结肱动脉切开取栓术治疗急性上肢动脉栓塞的经验，讨论急性上肢动脉栓塞的诊断和治疗。方法 1995-2007年中山大学附属第一医院血管外科共诊治28例急性上肢动脉栓塞病人，全部采用肱动脉切开取栓术治疗，术后予以序贯性抗凝。 结果 术后27例上肢供血良好，可触及桡动脉搏动。上肢再栓塞1例，合并其他部位栓塞3例。术后死亡3例，死亡原因为心肌梗死和脑栓塞。 结论 肱动脉切开取栓术是治疗上肢急性动脉栓塞的手术方式。防止再栓塞和治疗原发病是降低病死率和预防截肢的关键。

关键词: 上肢, 动脉栓塞, 动脉切开术, 取栓术

Abstract:

Diagnosis and surgical treatment of acute arterial embolism of upper extremities LI Song-qi, YE Cai-sheng, HU Zuo-jun, et al. Department of Vascular Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080,China Corresponding author:WANG Shen-ming, E-mail: shenmingwang@vip.sohu.com Abstract Objective To summary the experience of brachial arteriotomy with embolectomy to treat acute embolism of the upper extremities retrospectively and discuss the diagnosis and treatment of it. Methods From 1995 to 2007, 28 cases were performed brachial arteriotomy and were given sequential anticoagulants. Results After operation the upper extremities were salvaged in 27 cases，1 case accepted amputation, 1 case Re-embolism 2 times. 3 cases Re-embolism in other vessels and 3 cases died of cerebral embolism and acut myocardial infarction. Conclusion Brachial arteriotomy with embolectomy is an approach to treat acute embolism of upper extremities and how to prevent re-embolism and treat primary heart disease is the key to decrease mortality and amputation rate.

Key words: upper extremities, embolism, arteriotomy； embolectomy