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目的探讨应用导管接触溶栓(CDT)治疗军事训练伤后继发动脉血栓形成的临床效果。方法 2005年3月—2013年3月解放军107医院血管外科收治四肢军事训练伤后继发动脉血栓形成43例,均给予CDT治疗,其中单纯CDT 22例,CDT+腔内球囊扩张成形(PTA)17例,CDT+PTA+支架置入4例。结果导管溶栓时间为(3.0±2.2)d。本组治愈率为74.4%,总有效率为100.0%。2例(4.7%)溶栓过程中发生二次栓塞予调整导管位置后继续溶栓,5例(11.6%)溶栓过程中发生小腿骨筋膜室综合征行骨筋膜室切开减压术,均保趾、保肢成功。43例均术后随访(48.3±19.4)个月,无症状加重或复发。结论 CDT治疗四肢军事训练伤后继发动脉血栓形成是一种安全、有效、微创的方法,适于战时伤病员的救治与后送。
Objective To investigate the clinical effects of catheterized thrombolytic therapy (CDT) in the treatment of secondary thrombosis after military training injury. Methods From March 2005 to March 2013, 43 cases of secondary thrombosis after military training of limbs in PLA Department of Surgery, PLA Hospital were treated with CDT, including 22 cases of pure CDT and 17 cases of PTA. Cases, CDT + PTA + stent placement in 4 cases. Results The catheter thrombolysis time was (3.0 ± 2.2) days. The cure rate was 74.4%, the total effective rate was 100.0%. In 2 patients (4.7%), second embolization occurred during thrombolysis to continue the thrombolysis after catheter placement and in 5 patients (11.6%) thigh fascia syndrome occurred during thrombolysis. Surgery, both toe, limb salvage success. All 43 patients were followed up (48.3 ± 19.4) months, with no symptoms or recurrence. Conclusion CDT is a safe, effective and minimally invasive method for the treatment of secondary thrombosis after military training of limbs. It is suitable for the treatment and evacuation of wounded and sick patients in wartime.