大连医科大学学报
大連醫科大學學報
대련의과대학학보
JOURNAL OF DALIAN MEDICAL UNIVERSITY
2013年
6期
578-581
,共4页
动脉硬化闭塞%自体静脉%旁路术
動脈硬化閉塞%自體靜脈%徬路術
동맥경화폐새%자체정맥%방로술
arteriosclerosis obliterans%autogenous vein%bypass grafts
目的：探讨自体静脉旁路移植术在治疗下肢动脉硬化闭塞症中的作用。方法回顾性分析2004年1月-2012年7月应用自体静脉旁路移植术治疗的35例伴重症下肢缺血的下肢动脉硬化闭塞症患者的临床资料。所有病例均表现为下肢静息痛和/或溃疡、坏死，术前血管造影显示下肢动脉节段性闭塞为TASC C或D级病变。下肢血流重建采用以自体大隐静脉为移植物的动脉旁路手术。结果35例中34例（97．1％）术后患肢静息痛消失，皮肤温度、颜色明显改善，踝肱指数均值由术前0．11±0．13升为术后0．91±0．23，两者之间差异有显著性意义（P＜0．001）。术后随访30例，随访时间1～5年（平均3．5年），术后1、3、5年移植血管的一期累计通畅率分别为91％、80％、75％，二期累计通畅率分别为95％、83％、77％。结论自体静脉旁路移植术是治疗动脉硬化性重症下肢缺血，挽救患者肢体的有效方法。
目的：探討自體靜脈徬路移植術在治療下肢動脈硬化閉塞癥中的作用。方法迴顧性分析2004年1月-2012年7月應用自體靜脈徬路移植術治療的35例伴重癥下肢缺血的下肢動脈硬化閉塞癥患者的臨床資料。所有病例均錶現為下肢靜息痛和/或潰瘍、壞死，術前血管造影顯示下肢動脈節段性閉塞為TASC C或D級病變。下肢血流重建採用以自體大隱靜脈為移植物的動脈徬路手術。結果35例中34例（97．1％）術後患肢靜息痛消失，皮膚溫度、顏色明顯改善，踝肱指數均值由術前0．11±0．13升為術後0．91±0．23，兩者之間差異有顯著性意義（P＜0．001）。術後隨訪30例，隨訪時間1～5年（平均3．5年），術後1、3、5年移植血管的一期纍計通暢率分彆為91％、80％、75％，二期纍計通暢率分彆為95％、83％、77％。結論自體靜脈徬路移植術是治療動脈硬化性重癥下肢缺血，輓救患者肢體的有效方法。
목적：탐토자체정맥방로이식술재치료하지동맥경화폐새증중적작용。방법회고성분석2004년1월-2012년7월응용자체정맥방로이식술치료적35례반중증하지결혈적하지동맥경화폐새증환자적림상자료。소유병례균표현위하지정식통화/혹궤양、배사，술전혈관조영현시하지동맥절단성폐새위TASC C혹D급병변。하지혈류중건채용이자체대은정맥위이식물적동맥방로수술。결과35례중34례（97．1％）술후환지정식통소실，피부온도、안색명현개선，과굉지수균치유술전0．11±0．13승위술후0．91±0．23，량자지간차이유현저성의의（P＜0．001）。술후수방30례，수방시간1～5년（평균3．5년），술후1、3、5년이식혈관적일기루계통창솔분별위91％、80％、75％，이기루계통창솔분별위95％、83％、77％。결론자체정맥방로이식술시치료동맥경화성중증하지결혈，만구환자지체적유효방법。
Objective To assess the clinical effects of autogenous vein bypass grafts for the treatment of lower limb arterio -sclerosis obliterans .Methods We retrospectively analyzed 35 patients of lower limb arteriosclerosis obliterans with critical lower limb ischemia , for which autogenous vein bypass grafts were performed from January 2004 to August 2012 .Clinical manifestations in these patients were resting pain and /or ulcer/necrosis of the lower limb , in which preoperative angiogra-phy showed segmental TASC C , D occlusive lesions .Blood stream of the lower limb was reconstructed by bypass surgery u-sing autogenous saphenous vein grafts .Results In 34 cases (97.1%) symptoms were relieved, with resting pain disap-peared and skin temperature improved .Ankle brachial index ( ABI) increased significantly from 0.11 ±0.13 to 0.91 ± 0.23 perioperatively (P<0.001).Postoperatively, 30 cases were followed up for 1 year to 5 years.The primary graft pa-tency rates in this series were 91%, 80%and 75%in 1 year, 3 years and 5 years, respectively.The secondary graft pa-tency rates were 95%, 83%and 77%in 1 year, 3 years and 5 years, respectively.Conclusion Autogenous vein bypass graft is an effective method for the treatment of lower extremity ischemia due to arteriosclerosis obliterans and the salvage of the limbs.
