DSA引导下双腔Fogarty球囊导管在联合血栓中应用的临床研究
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摘要
目的观察DSA引导下双腔Fogarty球囊导管在断肢再植术后联合血栓中应用的临床疗效。方法回顾我院自2012年1月至2016年10月,DSA引导下应用双腔Fogarty球囊导管处理断肢再植术后发生联合血栓的患者15例,14例顺利成活,切口均I期愈合,1例患肢术后再次出现联合血栓血管危象,改行切开探查术。结果排除切开探查术的1例患者,采用Fogarty球囊导管处理的14例患者,血栓均存在于动脉内,取出的血栓长度0.5cm~4.8cm,均长期随访,肢体血运良好,皮温、感觉及活动度改善。参照中华医学会手外科学分会断肢再植功能评定试用标准评价疗效,本组优7例、良5例、差2例,优良率85.7%。结论 DSA引导下双腔Fogarty球囊导管处理断肢再植术后联合血栓,手术创伤小,快速改善患肢缺血症状,临床疗效满意。
Objective To observe the clinical curative effect application of DSA guided double lumen Fogarty balloon catheter in combined thrombosis after limb replantation.Methods Review 15 cases of patients with combined thrombosis after limb replantation using double lumen Fogarty balloon catheter under the guidance of DSA in the hospital from January 2012 to October2016,14 cases survived and the incision healed was in I stage,1 case suffered from recurrence of combined thrombosis crisis after operation,and it was converted to open exploration. Results 1 case of incision was excluded,thrombosis of 14 cases of patients treated with Fogarty balloon catheter were found in the arteries,and the thrombus length was 0. 5 cm ~ 4. 8 cm. They were all the long-term follow-ups,had good body blood circulation,and their skin temperature,feeling and activity were improved. According to the functional evaluation criteria of replantation of severed limb published by hand surgery of Chinese Medical Association,excellent in 7 cases,good in 5 cases and poor in 2 cases,the excellent rate was 85. 7%.Conclution DSA guided double lumen Fogarty balloon catheter in combined thrombosis after limb replantation had less surgical trauma,could improve limb ischemia symptomsrapidly,and it had satisfactory clinical efficacy.
Objective To observe the clinical curative effect application of DSA guided double lumen Fogarty balloon catheter in combined thrombosis after limb replantation.Methods Review 15 cases of patients with combined thrombosis after limb replantation using double lumen Fogarty balloon catheter under the guidance of DSA in the hospital from January 2012 to October2016,14 cases survived and the incision healed was in I stage,1 case suffered from recurrence of combined thrombosis crisis after operation,and it was converted to open exploration. Results 1 case of incision was excluded,thrombosis of 14 cases of patients treated with Fogarty balloon catheter were found in the arteries,and the thrombus length was 0. 5 cm ~ 4. 8 cm. They were all the long-term follow-ups,had good body blood circulation,and their skin temperature,feeling and activity were improved. According to the functional evaluation criteria of replantation of severed limb published by hand surgery of Chinese Medical Association,excellent in 7 cases,good in 5 cases and poor in 2 cases,the excellent rate was 85. 7%.Conclution DSA guided double lumen Fogarty balloon catheter in combined thrombosis after limb replantation had less surgical trauma,could improve limb ischemia symptomsrapidly,and it had satisfactory clinical efficacy.
引文
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[17]张旭,李果山,刘志贤,等.断肢再植19例治疗体会[J].中华显微外科杂志,2015,38(5):494-497.
[2]张子清,杨延军,马立峰,等.十指与双前臂同时离断再植成功一例及文献复习[J].中华显微外科杂志,2016,39(4):348-350.
[3]张丽峰,曾伟,刘源,等.杂交手术治疗急性下肢动脉栓塞的临床疗效分析[J].西部医学,2016,28(12):1719-1722.
[4]周喆刚,万圣祥,肖颖锋,等.游离皮瓣失败病例的原因及临床处理结果分析[J].实用骨科杂志,2016,22(9):802-805.
[5]张旭,李果山,刘志贤,等.断肢再植19例治疗体会[J].中华显微外科杂志,2015,38(5):494-497.
[6]龚凯,黄道景,张亚明.急性下肢缺血诊治的临床分析[J].中国实用医药,2017,12(3):14-16.
[7]Wong A K,Joanna Nguyen T,Peric M,et al.Analysis of the risk factors associated with microvascular free flap failure using a multi-institutional database[J].Microsurgery,2015,35(1):6-12.
[8]姜燕,谢毅,钱媛,等.Fogarty球囊导管在动静脉内瘘取栓中的应用[J].重庆医学,2015,44(36):5123-5125.
[9]李小东,刘士波,严晓薇,等.Fogarty球囊导管在断肢再植术后动脉危象中的应用[J].中国煤炭工业医学杂志,2017,20(4):409-412.
[10]李士民,刘林嶓,周树萍,等.Fogarty导管取栓术治疗手部血管药物栓塞[J].实用手外科杂志,2016,30(3):279-280.
[11]孙晓磊,王伟明,张雷,等.下腔静脉滤器联合顺行置管溶栓在下肢急性深静脉血栓形成中的疗效分析[J].四川医学,2016,37(9):1030-1033.
[12]贺海朋,殷恒讳,王冕,等.单腔与双腔Fogany导管在急性下肢动脉栓塞治疗中的应用[J].中国血管外科杂志·电子版,2015,7(1):48-51.
[13]De DG,Setacci F,Sirignano P,et al.The combination of surgical embolectomy and endovascular techniques May improve outcomes of patients with acute lower limb ischemia[J].Vascular Surg,2014,59(3):729-736.
[14]殷恒讳,王冕,李梓伦,等.双腔导管取栓治疗慢性下肢动脉栓塞疗效分析[J].中国血管外科杂志·电子版,2016,8(1):24-27.
[15]王弼偲,崔驰.DoradoTM高压球囊治疗自体动静脉内瘘再闭塞的疗效观察[J].四川医学,2016,37(12):1341-1344.
[16]冉坤,曾秋,傅麒宁,等.置管溶栓在下肢动脉支架内血栓形成治疗中的应用[J].血管及腔内血管外科杂志,2016,2,(4):335-340.
[17]张旭,李果山,刘志贤,等.断肢再植19例治疗体会[J].中华显微外科杂志,2015,38(5):494-497.