CAJ | 학술논문

目的探讨杂交手术对下肢多节段动脉闭塞性病变的治疗效果.方法回顾性分析2007年5月至2009年8月接受杂交手术的32例(35条下肢)多节段动脉闭塞性病变的临床资料,探讨杂交手术的适应证、治疗效果、并发症、围手术期死亡率、血管通畅率及保肢率.结果 33条患肢获得手术成功,成功率为94%(33/35).患者术后次日、术后6个月的踝肱指数(ABI)分别为1.06±0.17与0.96±0.16.与术前(0.49±0.18)相比,差异有统计学意义(P＜0.05).2例手术失败中1例因术中并发脑梗死,终止手术;1例膝下动脉开通失败而截肢,无围手术期死亡病例.26例患者获得随访,随访率87%(26/30);随访时间2～28个月,平均随访(11.0±1.3)个月.术后6个月动脉通畅率为93%(26/28),保肢率为96%(27/28).2例术后5～6个月膝下动脉再闭塞,其中1例引起肢端坏疽加重行膝下截肢术,另1例给予保守治疗.结论杂交手术对于下肢动脉多节段闭塞性病变具有较好效果,风险相对较低,近期通畅率较高.
목적 탐토잡교수술대하지다절단동맥폐새성병변적치료효과.방법 회고성분석2007년5월지2009년8월접수잡교수술적32례(35조하지)다절단동맥폐새성병변적림상자료,탐토잡교수술적괄응증、치료효과、병발증、위수술기사망솔、혈관통창솔급보지솔.결과 33조환지획득수술성공,성공솔위94%(33/35).환자술후차일、술후6개월적과굉지수(ABI)분별위1.06±0.17여0.96±0.16.여술전(0.49±0.18)상비,차이유통계학의의(P＜0.05).2례수술실패중1례인술중병발뇌경사,종지수술;1례슬하동맥개통실패이절지,무위수술기사망병례.26례환자획득수방,수방솔87%(26/30);수방시간2～28개월,평균수방(11.0±1.3)개월.술후6개월동맥통창솔위93%(26/28),보지솔위96%(27/28).2례술후5～6개월슬하동맥재폐새,기중1례인기지단배저가중행슬하절지술,령1례급여보수치료.결론 잡교수술대우하지동맥다절단폐새성병변구유교호효과,풍험상대교저,근기통창솔교고.
Objective To evaluate hybrid operation for arteriosclerosis obliterans (ASO) of the lower extremity. Methods Clinical data of 35 ischemic limbs in 32 ASO cases receiving hybrid operation from May, 2007 to August, 2009 were retrospectively analysed. The indications, clinical result,complications, perioperative mortality, vascular patency rate and limb salvage rate was evaluated.Results Thirty-five ischemic limbs in 32 cases underwent hybrid operation. Procedures were successful in 94％ cases (33/35). The average postoperative ABI significantly increased from 0.49 ±0. 18 to 1.06 ± 0. 17 ( one day after surgery) or 0. 96 ± 0. 16 ( six months after therapy). One patient suffered limb amputation due to surgical failure, one case was complicated with cerebral infarction and the operation was terminated. No patient died in perioperative period. Twenty-six cases (28 ischemia limbs) were followed-up from 2 month to 28 months, the follow-up rate was 87％ (26/30). Vascular patency rate in 6 months after operation was 93％ (26/28), and limb salvage rate was 96％ (27/28). Two cases suffered from below-knee reocclusion 5 -6 months after therapy, and one of these two cases needed a limb amputation.Conclusion Hybrid operation is the therapy of choice for multifocal lesions in arteriosclerosis obliterans of the lower extremities with a low risk and higher patency in short term.