解剖外腋-股、股-股动脉旁路移植术治疗主髂动脉闭塞症  

Extraanatomy axillaryfemoral or femorofemoral bypass grafting for the treatment of aortailiac occlusive disease

作　　者：叶建荣[1] 王玉琦[1] 范隆华[1] 陈福真[1] 符伟国[1] 

机构地区：[1]上海医科大学中山医院血管外科

出　　处：《中华外科杂志》1998年第8期457-458,共2页Chinese Journal of Surgery

摘　　要：目的探讨解剖外腋股、股股动脉旁路移植术治疗主髂动脉闭塞症的疗效。方法采用解剖外旁路移植术治疗主髂动脉闭塞症患者３２例。１８例腹主动脉或两侧髂动脉闭塞者采用腋股动脉旁路术，其中２例为腋两股动脉旁路术；１４例单侧髂动脉闭塞者采用股对侧股动脉旁路术。采用腋股动脉旁路的患者，术中８例用真丝人造血管移植，１０例用聚四氟乙烯（ＧｏｒｅＴｅｘ）人造血管；股股动脉旁路术中６例用真丝人造血管移植，１例用自体大隐静脉，７例用ＧｏｒｅＴｅｘ人造血管。结果术后５年随访时，股股动脉旁路术通畅率为７８％，其中真丝人造血管与ＧｏｒｅＴｅｘ人造血管通畅率无明显差异；腋股动脉旁路术中，８例真丝人造血管均已闭塞，１０例ＧｏｒｅＴｅｘ人造血管中１例闭塞，１例发生腹股沟部假性动脉瘤。结论解剖外动脉旁路移植术操作简单，创伤小，无腹部手术并发症，手术安全，术后恢复快。Objective To study the result of extraanatomy axillaryfemoral or femorofemoral bypass grafting which was performed to treat aortailiac arterial occlusive disease. Method From 1978 throug 1997,32 patients with aortailiac occlusive disease underwent extraanatomy axillaryfemoral or femorofemoral bypass grafting at our hospital.Eighteen patients with aorta or bilateral iliac artery occlusive lesion underwent axillaryfemoral artery bypass,including axillarybifemoral artery bypass(2 patients).Fourteen patients with one side iliac arterial occlusive lesion received femorofemoral bypass grafting.In who had had axillaryfemoral artery bypass 18 patients,8 received,pure silk prosthesis,and 10 GoreTex prosthesis.In femorofemoral arterial bypass,pure silk prosthesis was given to 8 patients,saphenous vein to one, and GoreTex prosthesis to 7. Result Followup for 5 years, a patency rate of 78% was achieved in femorofemoral artery bypass, in which no different patency rate was found between pure silk prosthesis and GoreTex prosthesis. In axillaryfemoral bypass, eight pure silk prostheses were occluded after 5year followup.One of 10 GoreTex prostheses was occluded,and false aneurysm in groin was found in another patient. Conclusion This operation is easy and safe,it has less damage and no abdominal complication. The recovery of the patient is quick.Pure silk prostheses are only used in short segment femorofemoral bypass grafting.

关 键 词：血管成形术 人工血管 主髂动脉闭塞症 

分 类 号：R654.3[医药卫生—外科学]