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目的:观察对比急性下肢动脉栓塞(AAELE)与急性血栓(AAT)的临床特征。方法:回顾性分析2013年1月-2015年11月我院75例AAELE或者AAT患者的临床资料,根据造影结果分为AAELE组53例和AAT组22例。对比两组患者梗阻部位及发病位置,统计分析两组患者合并症和既往疾病史情况,记录患者的临床表现及缺血程度分级。结果:AAELE组在髂股动脉梗阻发生率为54.72%,显著高于AAT组的27.27%,差异有统计学意义(P<0.05)。AAELE组的房颤和既往栓塞史的比例为67.92%、24.53%,均分别显著高于AAT组的22.73%、0.00%,伴高血压、糖尿病及吸烟史的比例为50.94%、28.30%、35.85%,均分别显著低于AAT组的86.36%、72.73%、72.73%,差异均有统计学意义(均P<0.05)。AAELE组的感觉异常、运动障碍、对侧动脉搏动及缺血程度Ⅱb级的比例为86.79%、64.15%、81.13%及54.72%,均分别显著高于AAT组的63.64%、27.27%、31.82%及27.27%,而间歇性跛行及缺血程度Ⅱa级的比例为24.53%、33.96%,均分别显著低于AAT组的63.64%、63.64%,差异均有统计学意义(均P<0.05)。结论:AAELE与AAT在临床症状、梗塞部位、合并症及既往疾病史、缺血程度方面表现均具有差异,临床掌握这些差异有助于更加准确地辅助判断患者的病情症状,值得重视。
Objective: To observe the clinical characteristics of acute lower extremity arterial embolism (AAELE) and acute thrombosis (AAT). Methods: The clinical data of 75 patients with AAELE or AAT in our hospital from January 2013 to November 2015 were retrospectively analyzed. According to the angiographic results, 53 patients were divided into AAELE group and 22 patients with AAT. Comparing the two groups of patients with obstructive site and the location of onset, statistical analysis of two groups of patients with comorbidities and past medical history, recording the clinical manifestations and grade of ischemia. Results: The incidence of ileal femoral artery obstruction in AAELE group was 54.72%, which was significantly higher than that in AAT group (27.27%), the difference was statistically significant (P <0.05). The proportions of atrial fibrillation and previous embolism in AAELE group were 67.92% and 24.53%, respectively, which were significantly higher than those in AAT group (22.73%, 0.00%, 50.94%, 28.30% and 35.85% respectively) %, Respectively, were significantly lower than the AAT group of 86.36%, 72.73%, 72.73%, the difference was statistically significant (P <0.05). The sensory abnormalities in AAELE group were 86.79%, 64.15%, 81.13% and 54.72%, respectively, which were significantly higher than those in AAT group (63.64%, 27.27%, 31.82% And 27.27% respectively, while the rates of class Ⅱa and intermittent claudication were 24.53% and 33.96%, respectively, which were significantly lower than 63.64% and 63.64% respectively in AAT group (all P <0.05). Conclusions: AAELE and AAT are different in clinical symptoms, infarction sites, comorbidities and past disease history and ischemia degree. To master these differences in clinical practice is more helpful in judging the symptoms of patients, so it deserves attention.