中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年
12期
985-987
,共3页
胡海地%刘翀%常青%任延英%蔡永昌%段志泉%张健%辛世杰
鬍海地%劉翀%常青%任延英%蔡永昌%段誌泉%張健%辛世傑
호해지%류충%상청%임연영%채영창%단지천%장건%신세걸
动脉瘤%血管外科手术%诊断
動脈瘤%血管外科手術%診斷
동맥류%혈관외과수술%진단
Aneurysm%Vascular surgical procedures%Diagnosis
目的 总结腘动脉瘤的外科诊治经验.方法 回顾性分析1988年1月至2012年1月间25例腘动脉瘤患者的临床资料,其中男21例,女4例,年龄13 ～72岁,平均(56±16)岁.病因为动脉粥样硬化18例,外伤6例,腘动脉陷迫综合征1例.本组症状主要为腘窝部搏动性肿物、患肢疼痛、急慢性远端缺血、患肢肿胀等.结果 25例患者中23例行手术治疗,其中17例行动脉瘤切除、自体大隐静脉移植术,4例行动脉瘤切除、人工血管移植术,1例行动脉瘤结扎术,1例行动脉瘤切除、对端吻合术.23例手术患者围手术期无死亡,1例患者术后第45天发生吻合口血栓形成,导致远端缺血坏死行膝上截肢术.术后21例(84％)获得随访,平均随访(6.5±0.5)年,1例双侧腘动脉瘤术后4年又发现右锁骨下动脉瘤,手术成功切除.另2例保守治疗.结论 腘动脉瘤可发生破裂或肢体远端缺血,积极手术治疗可获得良好治疗效果,并需加强术后随访.
目的 總結腘動脈瘤的外科診治經驗.方法 迴顧性分析1988年1月至2012年1月間25例腘動脈瘤患者的臨床資料,其中男21例,女4例,年齡13 ～72歲,平均(56±16)歲.病因為動脈粥樣硬化18例,外傷6例,腘動脈陷迫綜閤徵1例.本組癥狀主要為腘窩部搏動性腫物、患肢疼痛、急慢性遠耑缺血、患肢腫脹等.結果 25例患者中23例行手術治療,其中17例行動脈瘤切除、自體大隱靜脈移植術,4例行動脈瘤切除、人工血管移植術,1例行動脈瘤結扎術,1例行動脈瘤切除、對耑吻閤術.23例手術患者圍手術期無死亡,1例患者術後第45天髮生吻閤口血栓形成,導緻遠耑缺血壞死行膝上截肢術.術後21例(84％)穫得隨訪,平均隨訪(6.5±0.5)年,1例雙側腘動脈瘤術後4年又髮現右鎖骨下動脈瘤,手術成功切除.另2例保守治療.結論 腘動脈瘤可髮生破裂或肢體遠耑缺血,積極手術治療可穫得良好治療效果,併需加彊術後隨訪.
목적 총결객동맥류적외과진치경험.방법 회고성분석1988년1월지2012년1월간25례객동맥류환자적림상자료,기중남21례,녀4례,년령13 ～72세,평균(56±16)세.병인위동맥죽양경화18례,외상6례,객동맥함박종합정1례.본조증상주요위객와부박동성종물、환지동통、급만성원단결혈、환지종창등.결과 25례환자중23례행수술치료,기중17례행동맥류절제、자체대은정맥이식술,4례행동맥류절제、인공혈관이식술,1례행동맥류결찰술,1례행동맥류절제、대단문합술.23례수술환자위수술기무사망,1례환자술후제45천발생문합구혈전형성,도치원단결혈배사행슬상절지술.술후21례(84％)획득수방,평균수방(6.5±0.5)년,1례쌍측객동맥류술후4년우발현우쇄골하동맥류,수술성공절제.령2례보수치료.결론 객동맥류가발생파렬혹지체원단결혈,적겁수술치료가획득량호치료효과,병수가강술후수방.
Objective To evaluate surgical therapies in patients with popliteal aneurysms (PA).Method The clinical data of 25 PA patients admitted from January 1988 to January 2012 were retrospectively analyzed.There were 21 men and 4 women,the mean age was (56 ± 16)years.There were 27 PA in these 25 patients,with bilateral PA in 2 cases.The main symptoms were pulsatile mass in the popliteal fossa,limb pain,acute or chronic distal limb ischemia and limb edema.Result In this series 23out of 25 PA cases recieved operations,17 of them were treated with aneurysmectomy and saphenous vein interposition or bypass grafting,4 of them were treated with aneurysmectomy and prosthetic grafts interposition,1 was treated with aneurism ligation and 1 underwent end-to-end anastomosis after aneurysm resection.There was no perioperative mortality.One patient recieved amputation for distal anastomotic thrombosis and severe limb ischemia.The mean follow-up time is (6.5 ± 0.5) years.After 4 years,a right subclavian artery aneurysm was found in a bilateral PA case and treated surgically.Conclusions Early elective surgical treatment is recommended for patients with PA because PA may go rupture or induce dital limb ischemia and these patients may have good outcome after surgical treatment.Long-term follow-up is warranted to detect the new aneurysm formation.
