腹主动脉骑跨栓塞的外科治疗
Surgical treatment for abdominal saddle embolism
目的回顾对20例腹主动脉骑跨栓塞患者的诊治经验,总结出一套行之有效的治疗方法。方法经双侧股动脉Fogarty导管取栓术9例,经腹取栓术11例。结果 20例患者手术后共死亡6例,手术病死率33%。其中经双侧股动脉取栓者病死率11.1%,经腹取栓者病死率45.5%。术后3例共3条肢体因缺血坏死行截肢术。经平均14.1年随访,除4例死于原发心脏病外,余10例共19条肢体无严重血液循环障碍。结论根据患者病情的不同采取相应的术式是必要的,而及时准确的诊断及采用经双侧股动脉Fogarty导管取栓术可明显降低手术病死率。
更多Objective To study retrospectively the availability of embolectomy for abdominal saddle embolism.Methods Transfemoral embolectomy was performed in 9 cases and transaortic embolectomy in 11 cases.Results 6 of 20 cases died in postoperation with mortality rate of 33%,in that mortality rate of 45.5% was in cases with transaortic embolectomy and 11.1% with transfemoral embolectomy.Amputations were required in 3 of 14 survivors.4 died of heart diseases and 1 limb was dysfunctional in 14-year follow-up periods.Conclusion Prompt diagnosis and proper transfemoral embolectomy are helpful to reduce mortality.
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