探讨急性下肢缺血（ALLI）的临床特点及治疗方法。

回顾性分析2003年1月至2009年12月收治的ALLI患者的临床资料，根据病因将其分为急性动脉栓塞组（AE组）和急性血栓形成组（AT组），比较两组起病特点和治疗方法的异同，分析影响保肢的因素。

共收治130例ALLI，其中AE组82例，发病率略高，合并冠心病、风湿性心脏病、房颤者多，起病情况急，症状重，就诊时间多较短；AT组48例，冬季发病率较高，男性较多，平均年龄大，多有吸烟史，就诊时间相对较迟，并且多数有肢体慢性缺血病史。AE组脉搏消失、运动障碍症状出现率较AT组为高（P值分别为0.001和0.031），其他症状发生率两组之间差别无统计学意义。死亡9例，死亡率6.9%。一期截肢13例，二期截肢8例，总体保肢率为80.70%（88/109），AT组的总体截肢率、一期截肢率和二期截肢率均高于AE组（P值分别为1.0×10^-4, 4.2×10^-3, 0.051）。吸烟史、合并糖尿病和起病时间超过24 h是影响保肢的独立危险因素。

ALLI应当尽早治疗，动脉切开导管取栓是治疗急性动脉栓塞的有效方法，而治疗急性血栓形成应尽可能地完善术前评估，选择合适的综合治疗方案，必要时联合置管溶栓和（或）旁路治疗。

To investigate the clinical features and treatment of acute lower limb ischemia.

A retrospective analysis was carried out of patients who were admitted and treated for ALLI from January 2003 to December 2009.

82 cases of acute arterial embolism and 48 cases of acute thrombosis were studied. Clinical features: The overall incidence and co-incidence of CHD and AF was higher in the embolization group, and the patients in this group were treated earlier. In the acute thrombosis group: winter incidence was higher; men and smoking history were majority, older in average, and later for treatment. A systemic thrombolysis and anticoagulation therapy was taken in 12 cases and 9 patients undertook catheter thrombolysis. Fogarty catheter embolectomy procedures were performed in 81 cases, and 15 patients received immediate graft by-pass after the removal of thrombosis. An amputation was the first choice in 13 patients, and 8 patients underwent amputation of the second phase. A total of 27 patients underwent open decompression of compartment. Overall amputation rate was 16.15%; hospital mortality rate was 6.9%. Smoking, diabetes and onset time were independent risk factors for limb preservation.

ALLI should be treated as early as possible. Fogarty catheter embolectomy is effective for the acute arterial embolism. Preoperative assessment is important for acute arterial thrombosis and thrombolysis and/or graft by-pass should be used if necessary.