[传统局部动脉内纤维蛋白溶解、喷雾溶解和机械加速纤维蛋白溶解。对它们在血管成形术技术谱中的地位评估]

[Conventional local intra-arterial fibrinolysis, spray lysis and mechanically accelerated fibrinolysis. An assessment of their position in the spectrum of angioplasty technics].

作者信息

Wagner H J, Starck E, Alfke H, Reuter P

机构信息

Abteilung Strahlendiagnostik des Medizinischen Zentrums für Radiologie, Philipps-Universität Marburg.

出版信息

Rofo. 1993 Nov;159(5):466-70. doi: 10.1055/s-2008-1032799.

DOI:10.1055/s-2008-1032799

PMID:8219142

Abstract

Intra-arterial local fibrinolysis was performed in 72 patients (51 men, 21 women, mean age 66.8 years) during the course of 78 angioplasties. 11.1% were stage IIa (Fontaine), 38.9% were stage II b, 27.8% were stage III and 22.2% were stage IV. The methods used were conventional fibrinolysis (15.4%), spray lysis (47.4%) and mechanically accelerated fibrinolysis (37.2%). In 66.7% the urokinase dose was < 600,000 I.U., in 17.9% it was > 1,000,000 I.U. Additional balloon dilatation was performed in 72 cases, percutaneous aspiration of thrombo-embolic material in 41 cases and stent implantation in 7 cases. Angiographically the procedure was successful in 90.7%; the Doppler index rose from 0.47 +/- 0.27 to 0.85 +/- 0.3 (p < 0.001). At discharge, staging was: I = 38.9%, IIa = 38.9%, IIb = 5.6%, III = 1.4%, IV = 15.3%. There were no systemic bleeding complications. In 5.1%, complications had to be treated surgically.

摘要

在78次血管成形术过程中，对72例患者（51例男性，21例女性，平均年龄66.8岁）进行了动脉内局部纤维蛋白溶解治疗。11.1%为IIa期（Fontaine分期），38.9%为IIb期，27.8%为III期，22.2%为IV期。使用的方法有传统纤维蛋白溶解（15.4%）、喷射溶解（47.4%）和机械加速纤维蛋白溶解（37.2%）。66.7%的患者尿激酶剂量<600,000国际单位，17.9%的患者尿激酶剂量>1,000,000国际单位。72例患者进行了额外的球囊扩张，41例患者进行了经皮血栓栓塞物质抽吸，7例患者进行了支架植入。血管造影显示该手术成功率为90.7%；多普勒指数从0.47±0.27升至0.85±0.3（p<0.001）。出院时，分期情况为：I期=38.9%，IIa期=38.9%，IIb期=5.6%，III期=1.4%，IV期=15.3%。未出现全身出血并发症。5.1%的患者并发症需要手术治疗。