Hussein E A, el Dorri A
Surgery Department, Ain Shams University, Cairo, Egypt.
Int Surg. 1993 Jan-Mar;78(1):54-8.
Selective low-dose intra-arterial streptokinase was used in 11 long standing, complicated cases of Buerger's disease of the lower limbs suffering from acute exacerbations or thrombotic episodes with resulting variable degrees of gangrene or pre-gangrene of toes or feet, often despite previous lumbar sympathectomy. They had no other possible therapeutic options but wait for major amputation. The overall success rate (with amputation avoided or altered) was 58.3% and bleeding complications occurred in 16.6% of the total limbs at risk included. Favorable factors influencing the therapeutic outcome of thrombolytic therapy were a shorter presentation time, previous sympathectomy and nicotine abstinence. Even with necessary precautions, the technique does not seem to be totally safe. However it can be rewarded in some properly selected cases.
对于11例长期患有复杂下肢血栓闭塞性脉管炎的患者，在其病情急性加重或出现血栓形成发作，导致不同程度的足趾或足部坏疽或濒死期坏疽（即使此前已行腰交感神经切除术）时，采用了选择性低剂量动脉内链激酶治疗。他们没有其他可能的治疗选择，只能等待大截肢。总体成功率（避免或改变截肢）为58.3%，在纳入的所有有风险肢体中，16.6%发生了出血并发症。影响溶栓治疗效果的有利因素为发病时间较短、既往行交感神经切除术和戒烟。即使采取了必要的预防措施，该技术似乎也并非完全安全。然而，在一些经过适当选择的病例中，它可能会有成效。
