The Integrated Therapy Of Traditional Chinese & Western Medicine Of Acute Arterial Embolism In The Extremities

ObjectiveTo explore the curative effect of the integrated therapy of traditional Chinese & Western medicine to acute arterial embolism In the extremities.Methods1.Observation object:34 cases of acute arterial embolism in the extremities treated by Fogarty catheter and traditional Chinese medicine during 2001-06/2006-06 in our hospital was ariaiyzed .20 among those examples are male,and 14 female.The age scope is 21-72 years old(average 50.4±5.8 y) Course of diseases from 1hour to 7 days2.Diagnostic therapeutic method:All 34 cases were diagnosed through the check of Color Doppler and affirmed the position of embolism. 1 case was found the embolism in the middle segment of Left humeral artery and 1 case was found left radioartery. Next 2 in the left side of pelvic artery, right side 3.The left femoral crotch is 10, right side 13; The left side patellar artery is 1 and the right side be 40 29 of them embolism were localized in one single limb,while 5 were more,within the 5 cases, 3 were embolized simultaneity and 2 were successively .We detected in operation that in arteries of 28 cases(58.97%) there were succeeded embolism. All observation object were receieved sufficient pre-operative preparation, tight observation and sustainable treatment.And then treated by Fogarty catheter at continuous putamen anaesthesia .Carry on a treatment of thrombus liquefaction in the meantime. The maintain cardiac function and water- electrolyte balance, control infection after operation.Using heparin, narceine and low-molecule dextrose conventionality for 7 days,and then change to taking orally intestinal aspirin. Watching and treat it's cardiovascular primary affection.Patients in treatment group received treatments of Chinese traditional medicine after operation beside nomal ones.3.Examination.Treatments of embolism liquefaction before or after the operation must be examined rigorously to adjust dosage of drugs used.Indexes include Fbg,PT,APTT,andTT.4.Classification of curative effectAccording to the instauration of blood circulation , local symptom, general check and check of Color Doppler olor , consulted to Cooley standard, curative effect were divided into four grades:Clinical cure, show an effect, valid and inefficacy.Results1. None observation object death, 39 were all confirmed by surgicaloperation34 cases mitigated within 6～72 h , 5 come to hospital lated improveat at the 3-7 days.No one osteotomy as well as severe intercurrent subsequent diseases.2. Efficiency of curative and control group (clinical cure rate+show an efficiency) is 89.47% and 75.00% respectively.19 limbs in curative group, clinical cure 14, valid 3, show an effect 2, invalid o;Matched another 20 limbs in control group, clinical cure 10, valid 3, show an effect 4, invalid learn through statistics that difference between two groups were markede.Compared with control group,curative group is excel distinctly at symptom improvement degree, instauration of pulsate, rate to re-embolism etc.3. 1 case of curative group came forth re-embolism 3h after operation,and 2 in control group at 2d and 5d respectively.And all of them were gave emergency surgical operation, then the instauration be all right.4. The effect of operation of 3 cases dissatisfied of all for their embolism were underneath knee artery,the 3 patients had suffered intermettent claudication, and the symptom gradually alleviate in some sort after receive treatments of haemolytic, relieve hyperkinesia,anticoagulants and expand vas the symptom be a little bit improvement. Then after through the Chinese herbal medicine soup and patent medicine taking orally from 3 monthes to half year.ConclusionOutbreak suddenly, obvious symptom, quick progress, severe aftermath were all characteristics of acute extremity arterial embolism,and such a disease also have higher risk of mortality and physical disable.This was related to long-term blood lack and arterial embolism extended in the artery.Therefore, earlier diagnosis combine in time surgical operation treatment is the sticking point to reduce the rate of mortality and physical disable.All of the patients in this study were diagnosed by colored Doppler to definitude the location of embolism,hav no use for excessive of assistance check because it would delayed surgical operation opportune moment. So we should make surgical operation within 8 h as soon as possible. Intra arterial embolectomy using Fogarty catheter is a valid treatment for acute arterial embolism In the extremities. as soon as the diagnosis was confirmed, surgical operation should be made as early as possible to decrease the risk of limb putrescence.However, the death rate of single treatment of using Fogarty catheter were still at 30%～20% , and results causing death and osteotomy included primary diseases and severe complications. By our observation, the integrated therapy of Chinese traditional & Western medicine is significantly prior to pure western medicine to acute extremity arterial embolism, and it is a promising way in this field.adopt medium the doctor combine a therapy treatment impatient the body artery bolt to fill, more pure surgical operation and dissolve to bolt anti-Ning treatment to have obvious of advantage, can show Zhao to lower ill rate and piece limb rate, is very hopeful research direction.