Klemm P L, Boll A P, Buskens F G, Van Der Vliet J A
Academisch Ziekenhuis, afd. Heelkunde, sectie Vaat- en Transplantatiechirurgie, Nijmegen.
Ned Tijdschr Geneeskd. 1998 May 23;142(21):1177-82.
Bilateral acute lower limb ischaemia is rare. Usually the diagnosis is based on clinical findings. In four patients, three women aged 51, 48, and 72 and a man aged 64 years, bilateral acute ischaemia of the lower limbs was diagnosed, due to different causes: arterial cardiac myxoma embolism, arterial thrombosis probably due to paraneoplastic coagulopathy, aortic dissection, and arterial thrombosis due to cardiac insufficiency, respectively. The management of these conditions includes restoring the circulation as soon as possible. Reperfusion can be achieved by thromboembolectomy or thrombolysis. In patients with underlying atherosclerosis angiography is useful, but time loss must be avoided. The outcome in patients with bilateral ischaemia of the lower limbs depends on the preoperative ischaemia time and the cardiac situation. The mortality varies between 20 and 50%.
双侧急性下肢缺血较为罕见。通常依据临床症状进行诊断。有4例患者被诊断为双侧下肢急性缺血，其中3名女性，年龄分别为51岁、48岁和72岁，1名男性，年龄64岁，病因各不相同：分别为动脉性心脏黏液瘤栓塞、可能因副肿瘤性凝血病导致的动脉血栓形成、主动脉夹层以及因心功能不全导致的动脉血栓形成。这些病症的治疗包括尽快恢复血液循环。可通过血栓切除术或溶栓来实现再灌注。对于患有潜在动脉粥样硬化的患者，血管造影检查很有用，但必须避免延误时间。双侧下肢缺血患者的预后取决于术前缺血时间和心脏状况。死亡率在20%至50%之间。
