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下肢动脉硬化闭塞症的诊断治疗和预防 PowerPoint PPT Presentation


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下肢动脉硬化闭塞症的诊断治疗和预防. 首都医科大学附属北京安贞医院 血管外科 吴庆华. 病例介绍. 李 ×× ,男 63 岁, 10 年前出现双下肢间歇性跛行。步行约 1000 米后出现双侧下肢及臀部酸痛、无力,休息后症状消失,伴有双足的发凉和麻木。症状逐渐加重, 1 年前跛行距离缩短至不足 100 米。曾在当地长期按腰间盘突出治疗无效,近半年来右足出现持续性疼痛,夜间重,右足拇趾干性坏疽。. 病例介绍. 既往史 : 高血压病史 10 年 冠心病病史 5 年 腔隙性脑梗塞 5 年 无糖尿病病史 专科检查 :

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下肢动脉硬化闭塞症的诊断治疗和预防

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631010001100


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  • 10

  • 5

  • 5


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  • Arteriosclerosis obliterans, ASO


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:

/

ACS, ; TIA,


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  • >45>55


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Doppler

MRA

CTA

DSA


Doppler

Doppler--


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1

2

3


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1 PWV

PWV,<1400mm/s

2 AI

3


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1 IMT

IMT0.9mmIMT


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  • ABI

    0.9ABI1.3 0.4ABI0.9 ABI0.4ABI


Mra cta

MRA/CTA


94 90 mra 50 70 84 60 58 50

94%90% MRA50-70%84%60%58%50%


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CTA


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DSA


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40

1/4

1/31/2

1/4

Stoffers HE. Int J Epidemiol, 1996,25:282-290


1 5 8 7 2 7 9 3 23 1

15 8.7%27.9% 323.1%


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1

2

3

4

5


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C


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1.

50mg 1/

0.1-0.4mg/

INR

8;1-1.5mg/kg,6-8,ACT(), 0.6ml 1-2/

500 24,

(Cilostazol)2-(1H)(),200mg/, 50mg 2/,2/,6

(Ticlid)250mg 1-2/.

() 75mg 1/


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0.6ml2/7-10 12-3(TPK) () (Anplag) 5(5-HT2 )


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10mg)250ml250ml1212-33


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  • 1.-3(SVATE-3)

  • 

  • SVATE-3SVATE-3 SVATE-3: SVATE-3 3-6 u 500 ml 3

  • 75


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pleiotropic effects)


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2.()



2(150-100mg)


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SUPPLEMENT TO

J O U R N A L O F

VASCULAR

SURGERY

PART 2

JANUARY2000

VOLUME 31

NUMBER 1

TASC

Management of Peripheral Arterial Disease(PAD)

TransAtlantic Inter-Society Consensus( TASC)

Number 1, Part 2:S93

Section A: Introduction

Section B:Intermittent Claudication

Section C: Acute Limb Ischemia

Section D: Critical Limb Ischemia

Developedby the

TASC Working Group

Mosby

/

14

ASO

14

American College of Cardiology

Canadian Society for Vascular Surgery

Cardiovascular and Interventional Radiology Society ofEurope

European Society of Cardiology

European Society for Vascular Surgery

Society for Vascular Surgery

French Society of Vascular Surgery

College Francais de Pathologie Vasculaire

Society for Vascular Medicine and Biology

German Society of Angiology

German Society of Vascular Surgery

Society of Cardiovascular &Interventional Radiology

International Society for Cardiovascular Surgery

International Union of Angiology


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(Anplag) 5(5-HT2 )100mg tid


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1. ANPLAG,74%


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2. ANPLAG44%


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3.



2 - 32/0.6ml2/7-10 12-3(TPK)


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-


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170

2

3

4

5

6

7


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  • 1%~2%

  • -1%~3%


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+


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-


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  • -


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--300582%570%550%


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90%


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  • 3mm


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PAOD

360%


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  • (PTA)


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-


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,


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.


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,


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