中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2013年
1期
42-44
,共3页
动脉硬化,闭塞性%血管成形术%动脉旁路术%再闭塞
動脈硬化,閉塞性%血管成形術%動脈徬路術%再閉塞
동맥경화,폐새성%혈관성형술%동맥방로술%재폐새
Arteriosclerosis obliterans%Angioplasty%Graft bypass%Reocclusion
目的 总结下肢动脉硬化闭塞症治疗后再闭塞的治疗经验.方法 回顾性分析2007年1月至2011年12月70例患者的临床资料,其中30例单纯股-腘动脉旁路术、15例单纯腔内成形术、25例联合治疗后下肢单侧动脉再次闭塞.70例患者共发生98次动脉闭塞.10例次在发生末次闭塞时保守治疗(组),余88例次行手术治疗[包括单纯股或人工血管取栓15例次(单纯取栓组),取栓+局部动脉微导管置入(组)抗凝溶栓13例次,取栓+远端动脉成形+微导管置入抗凝溶栓60例次].结果 保守治疗组膝上截肢5例,失访2例.单纯取栓组膝上、下截肢各1例,失访2例.取栓+微导管置入组膝下截肢1例,死亡2例.取栓+动脉成形+微导管置入组急性肾衰转透析后失访1例.本组63例患者获得随访,随访时间8～60个月,平均(24±5)个月.其中44例血管通畅,通畅率69.8％.8例患者血管闭塞后截肢,总截肢率为12.7％.结论 对于动脉硬化闭塞症治疗后再闭塞的患者,取栓+腔内血管成形+微导管置入局部抗凝溶栓近期效果较好.
目的 總結下肢動脈硬化閉塞癥治療後再閉塞的治療經驗.方法 迴顧性分析2007年1月至2011年12月70例患者的臨床資料,其中30例單純股-腘動脈徬路術、15例單純腔內成形術、25例聯閤治療後下肢單側動脈再次閉塞.70例患者共髮生98次動脈閉塞.10例次在髮生末次閉塞時保守治療(組),餘88例次行手術治療[包括單純股或人工血管取栓15例次(單純取栓組),取栓+跼部動脈微導管置入(組)抗凝溶栓13例次,取栓+遠耑動脈成形+微導管置入抗凝溶栓60例次].結果 保守治療組膝上截肢5例,失訪2例.單純取栓組膝上、下截肢各1例,失訪2例.取栓+微導管置入組膝下截肢1例,死亡2例.取栓+動脈成形+微導管置入組急性腎衰轉透析後失訪1例.本組63例患者穫得隨訪,隨訪時間8～60箇月,平均(24±5)箇月.其中44例血管通暢,通暢率69.8％.8例患者血管閉塞後截肢,總截肢率為12.7％.結論 對于動脈硬化閉塞癥治療後再閉塞的患者,取栓+腔內血管成形+微導管置入跼部抗凝溶栓近期效果較好.
목적 총결하지동맥경화폐새증치료후재폐새적치료경험.방법 회고성분석2007년1월지2011년12월70례환자적림상자료,기중30례단순고-객동맥방로술、15례단순강내성형술、25례연합치료후하지단측동맥재차폐새.70례환자공발생98차동맥폐새.10례차재발생말차폐새시보수치료(조),여88례차행수술치료[포괄단순고혹인공혈관취전15례차(단순취전조),취전+국부동맥미도관치입(조)항응용전13례차,취전+원단동맥성형+미도관치입항응용전60례차].결과 보수치료조슬상절지5례,실방2례.단순취전조슬상、하절지각1례,실방2례.취전+미도관치입조슬하절지1례,사망2례.취전+동맥성형+미도관치입조급성신쇠전투석후실방1례.본조63례환자획득수방,수방시간8～60개월,평균(24±5)개월.기중44례혈관통창,통창솔69.8％.8례환자혈관폐새후절지,총절지솔위12.7％.결론 대우동맥경화폐새증치료후재폐새적환자,취전+강내혈관성형+미도관치입국부항응용전근기효과교호.
Objective To explore the experience in the treatment of postoperative reocclusion in patients of lower limb arterial occlusion.Methods From January 2007 to December 2011,clinical data were reviewed on 98 reocclusion episodes in 70 patients,who had been treated by graft bypass (30 patients),or angioplasty (15 patients) or both (25 patients).In this series,10 cases received conservative treatment and to the other 88 episodes reoperation was given,including thrombectomy alone in 15 episodes,and thrombectomy combined with microcatheter application for 13 episodes,and thrombectomy combined with angioplasty and microcatheter application for 60 episodes.Results Two patients died during follow-up period and 5 patients were lost to follow-up including 2 receiving conservative treatment.The other 63 patients were followed-up for 8 to 60 months,averaging (24 ± 5) months.The arterial patency in patients receiving reoperation treatment was 69.8％ (44 patients) and the amputation rate was 12.7％ (8 patients).Conclusions For postoperative recurrent arterial occlusion in patients of lower limb arterial occlusion,thrembectomy combined with angioplasty and microcatheter application may generate satisfactory results,
