自体大隐静脉旁路术治疗下肢动脉硬化闭塞症  

Autogenous vein grafting for the treatment of atherosclerotic occlusion of the lower limbs

作　　者：马中[1] 边杰芳[1] 王岭[1] 袁时芳[1] 张聚良[1] 宁莫凡[1] 

机构地区：[1]第四军医大学西京医院血管外科,西安710032

出　　处：《中华普通外科杂志》2006年第12期871-873,共3页Chinese Journal of General Surgery

基　　金：国家自然科学基金资助项目(30571827)

摘　　要：目的评价自体大隐静脉旁路术治疗下肢动脉硬化闭塞症的近、远期临床疗效。方法回顾性分析采用自体大隐静脉旁路术治疗下肢动脉硬化闭塞症90例的手术疗效及自体静脉移植物的近、远期通畅率。结果87例患者术后患肢缺血症状消失,临床表现为下肢疼痛消失,皮肤温度变暖,溃疡趋于愈合,踝肱指数均值术前0．38±0．11,术后升为0．85±0．18,两者相比差异有统计学意义(P<0．01),手术治疗总有效率为96．6％(87／90)。术后79例获得随访,随访时间1～3年,平均2年,自体移植静脉血管术后1、2、3年累计通畅率分别为94．9％、80．0％和60．7％。结论自体静脉移植具有取材简便、组织相容性好以及远期通畅率高等优点,是外科治疗下肢动脉硬化闭塞症的理想术式。Objective To evaluate the clinical effects of autogenous vein grafting for the treatment of atherosclerotic occlusion of the lower limbs. Methods Ninety cases of segemental atherosclerotic occlusion of the lower limbs underwent autogenous vein graft bridging procedures from Jan 2002 to Feb 2005 in our hospital. The immediate surgical results were compared with symptoms of pre-operation, and the longterm patency rate was evaluated. Results Total symptom relief was achieved in 87 cases, with the limbs pain disappearing, skin temperature going up, and the refractory ulcer tending to heal. There was a significant difference in ABI, perioperatively increasing from 0. 38 ±0. 11 to 0. 85 ±0. 18（P 〈 0. 01 ）. The overall effective rate of operation was 96. 6% （ 87/90 ）. Postoperative follow up was made in 79 cases （87.8%）. The 1,2, and 3 year＇s cumulative patency rate was 94. 9% （75/79）, 84. 8% （67/79） and 75.9% （60/79）, respectively. Conclusion Autogenous vein grafting is the best choice in the surgical treatment of atherosclerotic occlusion of the lower limbs because of easy performance, good tissue compatibility and high patency rate.

关 键 词：动脉硬化 闭塞性 移植 自体 大隐静脉 

分 类 号：R654.3[医药卫生—外科学]