后腹腔镜腰交感神经节切除术治疗血栓闭塞性脉管炎  

Video-assisted laparoscopic lumbar sympathectomy for the treatment of thromboangiitis obliterans

作　　者：张金池[1] 郑清水[2] 郭平凡[1] 蔡方刚[1] 刘学强[1] 

机构地区：[1]福建医科大学附属第一医院血管外科福建医科大学血管外科研究室,福州350005 [2]福建医科大学附属第一医院泌尿外科

出　　处：《中华实验外科杂志》2012年第9期1829-1830,共2页Chinese Journal of Experimental Surgery

摘　　要：目的探讨应用后腹腔镜下腰交感神经节切除术（VALLS）治疗血栓闭塞性脉管炎（TAO）的可行性和临床疗效。方法26例TAO患者施行了VALLS，观察术前术后疼痛（VAS评分）、皮温和跛距的变化以及术后并发症。结果VALLS技术成功率为100％，24例随访（随访牢92．31％）8～78个月，平均24个月，患者原有下肢临床症状改善或消失。术后3个月患肢疼痛VAS评分手术后（3．14±1．57）较手术前（7．684-1．66）有明显改善（t=38．12，P〈0．01）；患肢足背皮肤温度术后[（32．92±1．68）℃]比VALLS前[（31．21±1．55）℃]升高（t=4．93，P〈0．05）；跛行距离术后f（801．65±145．88）m]较手术前[（136．89±114．52）m]有明显改善（t=37．34，P〈0．01），没有严重并发症发生。结论VALLS技术成功率高，临床疗效满意，本组无严重并发症，治疗TAO安全、微创和有效。Objective To investigate the feasibility and outcomes of video-assisted laparoscopic lumbar sympathectomy （VALLS） for the treatment of thromboangiitis obliterans （TAO）. Methods Twen- ty-six patients with TAO were treated by VALLS. The changes of visual analogue scale （VAS） , skin tem- perature of foot, the distance of intermittent claudication and the postoperative complications were assessed perioperatively in all cases. Results The technical success rate of VALLS was 100%. The follow-up dura- tion （follow-up rate was 92. 31% ） was 8-78 months （mean 24 months）. Previous lower extremity clinic symptoms in all patients were alleviated or disappeared. The VAS scores post-operation were decreased markedly as compared with pre-operation [ （3.14 ± 1.57） vs （7.68 ± 1.66） ,t = 38. 12,P 〈0. 011 , post- operative skin temperature of foot and the distance of intermittent claudication were increased as compared with pre-operation [（32.92±1.68） ℃ vs. （31.21 ±1.55） ℃,t=4.93,P〈0.05; （801.65±145.88） m vs （ 136.89 ± 114. 52） m, t = 37.34, P 〈 0. 01 ]. No severe complications occurred. Conclusion VALLS is feasible with a high technical success rate and the clinical effective rate is satisfactory. It is a safe and effective as well as minimally invasive technique with no severe postoperative complications.

关 键 词：腹腔镜 腰交感神经节切除术 血栓闭塞性脉管炎 

分 类 号：R654.4[医药卫生—外科学]