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РЖ ВИНИТИ 76 (BI31) 95.09-04Т3.230

Intraoperative administration of rt-PA during a case of digital revascularization [Text] : abstr. and Invit. Lect. 12th Int. Congr. Fibrinolys., Leuven, Sept. 18-22, 1994 / J. M. Stassen [et al.] // Fibrinolysis. - 1994. - Vol. 8, Suppl. n 1. - P71 . - ISSN 0268-9499
Перевод заглавия: Применение rt-PA во время операции по поводу реваскулиризации пальцев
Аннотация: Following a power-saw injury to his right hand, a 27-year old man was admitted for emergency reconstruction. The 2nd, 3rd and 4th fingers were devascularised, and all dorsal and deep palmar structures including bone, were divided at the metacarpal necks. The palmar skin and the corresponding superficial venous network were in continuity. Prior to surgery, the patient received aspirin 250 mg PO and a total of 500 ml dextran 70. The microvascular repair was performed through the dorsal wound. An interpositional venous graft from the dorsum of the patient's left foot was interpositioned into the common digital artery of the 2nd and third fingers. A transient hyperemia was observed in all three fingers immediately upon removal of the vascular clamps, but a state of no reflow incurred within 5 minutes. A more extensive palmar dissection, which would have been necessary to allow further arterial resection and reconstruction, was considered a hazard to the existing palmar venous outflow. Intraoperative thrombolytic therapy was therefore started with intraarterial infusion of rt-PA 800 'мю'g/h through the radial artery, after a 400 'мю'g bolus. Signs of reperfusion were first observed 1.5 hrs after initiation of the infusion, which was then decreased to 400 'мю'g/h during 2 hrs, and finally to 200 'мю'g/h during 1 hr. A significant bleeding from the wound area necessitated the transfusion of two units of blood. Postoperatively, the restoration of the blood flow was confirmed using finger pulp temperature measurements and transcutaneous laser doppler flowmetry. Intraoperative thrombolytic therapy was successfully used to restore digital blood flow in a case of arterial reconstruction with sign of arterial thrombosis

ГРНТИ	76.31.29

ВИНИТИ 761.31.29.41.09
Рубрики: ХИРУРГИЧЕСКИЕ ОПЕРАЦИИ
РЕВАСКУЛИРИЗАЦИЯ ПАЛЬЦЕВ
АСПИРИН
ДЕКСТРАН
RT-PA
ВНУТРИАРТЕРИАЛЬНАЯ ИНФУЗИЯ
ДОЗЫ
ТЕРАПЕВТИЧЕСКИЙ ЭФФЕКТ
БОЛЬНЫЕ

Доп.точки доступа:
Stassen, J.M.; Gang, L.; Andreen, O.; Nystrom, E.; Nystrom, A.

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