摘要
目的 :探讨血栓闭塞性脉管炎介入治疗的可行性及有效性。方法 :对 13例血栓闭塞性脉管炎患者行左锁骨下动脉穿刺药盒置入术 ,将导管留置于患侧肢体髂外动脉 ,经导管药盒系统每日灌注前列腺素E1 (PGE1 ) 10 0 μg ,尿激酶 2 0万IU ,脉络宁 2 0ml。每个疗程 7～ 10d。结果 :所有患者血管造影显示 1例于股浅动脉中段闭塞 ,9例动脉水平完全闭塞 ,3例胫前动脉完全闭塞、胫后动脉和腓动脉远端闭塞。经治疗后 ,其中 3例已有坏疽者最终截肢 ,10例无坏疽者皮温升高 ,间歇性跛行和静息痛明显改善 ,行走距离均 >5 0 0m ,Fontain分级至少提高两级。其中 1例术后一年复查造影显示有大量侧支循环形成。结论 :①对未出现坏疽的脉管炎患者 ,导管药盒系统的序贯治疗 ,能有效改善下肢缺血症状 ,降低截肢率 ;对已有坏疽者 ,序贯治疗难以起到挽救肢体的作用。
Objective:To evaluate the clinical feasibility and effectiveness of port catheter system inplantation in treatment of thrombo angitis obliterans.Methods:13 patients with thrombo angitis obliterans were treated with percuta neous left subclavian artery port catheter system implantation,the catheter was placed in external iliac artery, transcatheter infusion of prostaglandin E1 (PGE1) 100μg,urokinase (UK) 200,000IU and mailuoning 20 ml was done every day.Each course of treatment lasted 7～10 days.Results:In all 13 patients,the angiography showed occlusion of superficial femoral artery (n=1),occlusion of popliteal artery (n=9),occlusion of anterior and posterial tibial artery and peroneal artery (n=3).After treatment 3 patients underwent amputation due to gangrene of foot.In 10 patients with no gangrene,the skin temperature of the lower limb rose,intermittent claudication and rest pain relieved obviously; the Fontain grade was improved by two grades at least. 1 patient underwent angiography one year after the proudure and it revealed formation of rich collaterals.Conclusion:①For patients with thrombo angitis with no gangren,the port catheter system implantation can improve the ischemia of the lower limbs and decrease the amputation rate.To those have been gangrehe,the treatment is difficult to gaving lower limb.②the port catheter system was shown to be a new and effective method to improve the clinical status of the patients with thrombo angiitis obliterans.
出处
《放射学实践》
2003年第12期882-884,共3页
Radiologic Practice
关键词
药盒置入术
治疗
血栓闭塞性脉管炎
临床研究
Thrombo angitis obliterans
Radiology,interventional
Port catheter system
Gangrene
