急性腹主动脉骑跨栓塞21例的治疗
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杨德华

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Treatment of acute abdominal aorta saddle embolism: a report of 21cases
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    目的:总结腹主动脉骑跨栓塞(abdominal aorta saddle embolism,ASE)的治疗经验和教训。方法:回顾性分析近6年来采用双股动脉Fogarty导管取栓等方法,治疗的腹主动脉骑跨栓塞21例的临床资料。 结果:血流再通后早期死亡4例,主要原因为高血钾引起的心搏骤停;迟发死亡6例,主要原因为急性肾功能衰竭为首发器官衰竭的多器官功能不全综合征;治愈11例,其中,5例保存了双侧肢体,6例截去单侧或双侧下肢。随访10例,存活肢体血运良好。结论:早期诊断,早期取栓治疗是降低腹主动脉骑跨栓塞病死率和截肢率的关键。术中预防高钾血症引起的心搏骤停、术后预防和及早治疗ARF是降低病死率的重要环节。

    Abstract:

    Abstract:Objective:To summarize our experience in treating abdominal aorta saddle embolism (ASE). Methods:The clinical data of 21 cases of abdominal ASE were treated with Fogarty catheter and other methods during January 2000 to July 2006 were retrospectively assessed. Results:After the blood flow was restored by operation, 4 died in the postoperative early stage because of sudden cardiac asystole due to hyperkalemia; in the late stage, 6 died of multiple organ dysfunction syndrome socondary from acute renal failure(ARF). Eleven patients were cured. Of them, bilateral lower extremites were salvaged in 5 patients; and 6 patients received amputation. Ten patients were followed up, and the blood supply of the salvaged legs was good. Conclusions:Early diagnosis and embotism removal are the key points to decrease the mortality and amputation rate of ASE. The intra-operative and post-operative prevention and management of hyperkalemia and ARF are important for reduction of mortality.

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杨德华,段志泉,辛世杰,张健,胡新华.急性腹主动脉骑跨栓塞21例的治疗[J].中国普通外科杂志,2006,15(12):7-904.
DOI:10.7659/j. issn.1005-6947.2006.12.007

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  • 在线发布日期: 2006-12-25