Chin A K, Fogarty T J
Postgrad Med. 1987 May 1;81(6):271-6. doi: 10.1080/00325481.1987.11699833.
Arterial embolism is usually caused by cardiac disease, and atherosclerotic coronary vascular disease is the primary precursor. Other cardiac states, as well as several uncommon causes, are part of the etiologic spectrum. The earliest signs are pain, paresthesias, pallor, and pulselessness. Severe ischemia is indicated by paralysis, a late feature. Arterial embolism and acute thrombosis can be difficult to distinguish, and deep venous thrombosis may also be suspected in the differential diagnosis. To restore arterial flow, anticoagulation treatment with heparin (Lipo-Hepin, Liquaemin) is given and surgical embolectomy is performed. Heparin infusion is continued until the patient is ambulatory, and then warfarin sodium (Coumadin, Panwarfin) is given over the long term. Fibrinolysis has also been used to treat acute arterial occlusion. Complications of embolism must be carefully guarded against, and additional procedures are sometimes necessary.
动脉栓塞通常由心脏疾病引起，动脉粥样硬化性冠状动脉疾病是主要的先兆。其他心脏状态以及一些罕见病因也在病因范围内。最早的症状是疼痛、感觉异常、苍白和无脉。瘫痪是严重缺血的表现，出现较晚。动脉栓塞和急性血栓形成可能难以区分，鉴别诊断时也可能怀疑深静脉血栓形成。为恢复动脉血流，给予肝素（利保肝素、肝素钠）进行抗凝治疗，并实施手术取栓术。持续输注肝素直至患者能够走动，然后长期给予华法林钠（香豆素、苄丙酮香豆素）。纤维蛋白溶解疗法也已用于治疗急性动脉闭塞。必须小心预防栓塞的并发症，有时还需要采取其他措施。
