CAJ | 학술논문

目的：总结腔内外联合一站式手术解决下肢动脉硬化性闭塞继发血栓的治疗经验。方法对86例下肢动脉硬化性闭塞继发血栓的临床资料进行回顾性分析。结果86例患者均在DSA下行腔内外联合手术，根据病变位置不同及每个患者的具体情况采取最有利的个性化手术治疗，植入支架64枚，人工血管转流23例次，86例患者均伴有远端流出道或流入道病变，均在术中使用球囊扩张。86例患者手术均获得成功，保肢率100%，1例术后3天死于肺梗。术后随访3个月至2年，随访率为93%（80/86），疗效满意。结论根据下肢动脉硬化性闭塞继发血栓形成的部位及狭窄或闭塞程度的不同，所以不能采取固定的模式去处理每位患者，腔内外联合一站式手术因为可以根据手术中具体情况而及时修订手术方向，是治疗下肢动脉硬化性闭塞继发血栓形成的有效手段。
목적：총결강내외연합일참식수술해결하지동맥경화성폐새계발혈전적치료경험。방법대86례하지동맥경화성폐새계발혈전적림상자료진행회고성분석。결과86례환자균재DSA하행강내외연합수술，근거병변위치불동급매개환자적구체정황채취최유리적개성화수술치료，식입지가64매，인공혈관전류23례차，86례환자균반유원단류출도혹류입도병변，균재술중사용구낭확장。86례환자수술균획득성공，보지솔100%，1례술후3천사우폐경。술후수방3개월지2년，수방솔위93%（80/86），료효만의。결론근거하지동맥경화성폐새계발혈전형성적부위급협착혹폐새정도적불동，소이불능채취고정적모식거처리매위환자，강내외연합일참식수술인위가이근거수술중구체정황이급시수정수술방향，시치료하지동맥경화성폐새계발혈전형성적유효수단。
Objective To summarize the clinical experience on endovascular and extravascular combination method for the treatment of the patients with lower extremity arteriosclerosis obliterans with thrombosis. Methods A retrospective analysis was made for 86 paitients with lower extremity arteriosclerosis obliterans with thrombosis underwent endovascular and extravascular combination method. Results 86 patients underwent endovascular and extravascular combination method under DSA according to the speciifc circumstances and the different lesion locations. 86 patients with lesions of distal outflow tract or inflow tract underwent balloon dilation with 64 stents implantation,of which 23 did artificial blood vessel bypass without any operative complications. The limb salvage rate was 100%. One patient died of pulmonary infarction after operative third day. The curative effect of all patients is satisfactory by follow-up from 3 months to 2 years with the follow-up rate of 93%. Conclusions Endovascular and extravascular combination method under DSA according to the speciifc circumstances and the different lesion locations is an effective modality for the treatment of the paitients suffering from lower extremity arteriosclerosis obliterans with thrombosis.