颈总动脉-锁骨下动脉旁路移植术治疗锁骨下动脉闭塞  

Carotid-subclavian bypass grafting for symptomatic subclavian artery occlusion

作　　者：李学锋[1] 余恒锡[1] 谷涌泉[1] 张建[1] 汪忠镐[1] 董宗俊[1] 齐力行[1] 

机构地区：[1]首都医科大学宣武医院血管外科,北京100053

出　　处：《中国普通外科杂志》2008年第6期539-541,共3页China Journal of General Surgery

摘　　要：目的探讨颈总-锁骨下动脉旁路移植术治疗锁骨下动脉闭塞症的临床疗效。方法采用颈总动脉-锁骨下动脉搭桥术治疗17例锁骨下动脉闭塞症患者。术前行动脉造影进行诊断,术后行超声多普勒检查确定移植血管通畅。结果17例患者术后症状明显改善,患侧与健侧上肢血压差<10mmHg(1mmHg=0.133kPa),患/健侧血压指数由术前0.64±0.12提高至0.98±0.10(P<0.01)。术后经平均7.1年随访,1年和5年移植血管通畅率分别为100%和94.1%,无中风及围手术期死亡发生。结论颈总-锁骨下动脉旁路移植术是一种安全、有效的术式,其远期通畅率高,尤适用于有良好的手术耐受性并要求高通畅率的患者。Objective To analyze the operative effect of carotid-subclavian bypass grafting for subclavian artery occlusion. Methods Seventeen patients with subclavian artery disease were diagnosed by arteriography and received carotid-subclavian bypass grafting. Graft patency was determined by Duplex ultrasound scan examinations. Results All 17 patients undergoing bypass grafting achieved immediate relief of symptoms. The blood pressure differences between the treated and the healthy arms were less than 10 mmHg after operation. The ratio of healthy/diseased side of the mean blood pressure index increased from 0.64 ± 0. 12 preoperatively to 0.98 ± 0.10 postoperatively （ P 〈 0.01 ）. No perioperative stroke or death occurred. By 7. 1 years of the mean follow-up, the patency rate at 1 and 5 years was 100% and 94. 1% , respectively. Conclusions Carotid-subclavian bypass grafting for subclavian artery disease has shown to be very safe and effective, and with excellent long-term patency. We think it shoud be offered to good-risk surgical candidates who may be seeking a more durable procedure.

关 键 词：动脉闭塞性疾病/外科学 锁骨下动脉 人工血管 颈总-锁骨下动脉旁路移植术 

分 类 号：R654.4[医药卫生—外科学]