CAJ | 학술논문

目的探讨旁路移植术在远端流出道不良所致严重下肢缺血患者中的应用价值.方法选取42例(共49条下肢)仅有小腿单支流出道动脉供血的严重下肢缺血患者作为研究对象,并行动脉旁路移植手术,手术方式主要有股-胭动脉人工血管-小腿动脉自体血管移植术、腘-小腿动脉自体血管移植术及胭-足背动脉自体血管移植术等,分析其血管通畅率等指标.结果 42例患者中,术后移植血管闭塞1例,闭塞率为2.4％(1/42),手术成功率为97.6％(41/42);1例在术后第4天因呼吸衰竭死亡,病死率为2.4％(1/42)；出院时血管通畅率为100.0％ (41/41),足部创面愈合率为33.3％(11/33).结论采用下肢远端动脉旁路移植术治疗仅有小腿单支流出道动脉供血的严重下肢缺血效果较明显,可为足部创面的愈合提供较好的营养环境,也可及早挽救肢体或降低截肢平面,对提高患者术后生活质量有较大价值.
목적 탐토방로이식술재원단류출도불량소치엄중하지결혈환자중적응용개치.방법 선취42례(공49조하지)부유소퇴단지류출도동맥공혈적엄중하지결혈환자작위연구대상,병행동맥방로이식수술,수술방식주요유고-연동맥인공혈관-소퇴동맥자체혈관이식술、객-소퇴동맥자체혈관이식술급연-족배동맥자체혈관이식술등,분석기혈관통창솔등지표.결과 42례환자중,술후이식혈관폐새1례,폐새솔위2.4％(1/42),수술성공솔위97.6％(41/42);1례재술후제4천인호흡쇠갈사망,병사솔위2.4％(1/42)；출원시혈관통창솔위100.0％ (41/41),족부창면유합솔위33.3％(11/33).결론 채용하지원단동맥방로이식술치료부유소퇴단지류출도동맥공혈적엄중하지결혈효과교명현,가위족부창면적유합제공교호적영양배경,야가급조만구지체혹강저절지평면,대제고환자술후생활질량유교대개치.
Objective To evaluate the value of bypass graft in the treatment of critical lower limb ischemia with distal single outflow artery.Methods Forty-nine lower limbs in 42 patients with single outflow artery were collected and underwent arterial bypass graft.The operation methods included femoropopliteal artificial graft to single outflow artery with autograftand popliteal artery to calf vessel and so on.The results were analyzed finally.Results All of 42 patients,postoperative grafts occlusion occured in 1 case,the occlusion rate was 2.4％(1/42) and the success rate was 97.6％(41/42),1 case died of respiratory failure 4 d postoperatively,the mortality was 2.4％(1/42).The patency rate of graft was 100.0％(41/41) on discharge.Healing rate of foot ulcer was 33.3％ (11/33).Conclusions It's difficult to reconstruct blood flow for critical ischemic limb with single outflow artery,but good result is still expected by distal lower limb bypass graft.Distal bypass can provide a better nutritional support for the healing of foot ulcer and result in a lower limb salvage or lowering of amputation level.