大隐静脉原位转流术治疗下肢Ⅲ、Ⅳ期动脉硬化闭塞症的疗效  

In situ great saphenous vein bypass for the treatment of Ⅲ、 Ⅳ arteriosclerosis obliterans of lower limb

作　　者：李玉斌[1] 孙艳艳[1] 姜同柏[1] 孙大军[2] 

机构地区：[1]山东大学附属临沂市人民医院血管外科,山东临沂276003 [2]吉林大学中日联谊医院血管外科,长春130033

出　　处：《山东大学学报（医学版）》2012年第11期92-95,共4页Journal of Shandong University:Health Sciences

摘　　要：目的探讨大隐静脉原位转流术治疗下肢FontaineⅢ、Ⅳ期动脉硬化闭塞症的疗效。方法应用THEBUSHTM瓣膜刀为26例患者行大隐静脉原位转流术。结果患者术后近期自觉症状均缓解,25例静息痛消失,皮温明显升高,溃疡愈合,坏死与正常组织间界限清楚。1例患者术后原位大隐静脉内血栓形成,于外院截肢,平均踝肱指数(ABI)由术前0.32提高到术后0.78。6、12、24个月的通畅率分别为96.1%、88.5%、80.8%。结论根据患者具体情况应用大隐静脉原位转流术,是治疗下肢动脉长距离、多节段、多平面狭窄或闭塞,临床表现为重症缺血的FontaineⅢ、Ⅳ期动脉硬化闭塞症的有效术式。Objective To evaluate the result of in situ great saphenouse vein bypass for the treatment of Fontaine Ⅲ、 Ⅳ arteriosclerosis obliterans of lower limb.Methods 26 patients with Fontaine Ⅲ、 Ⅳ arteriosclerosis obliterans of lower limb were treated with in situ great saphenouse vein bypass by using THE BUSHTM valvulotome.Results All cases of postoperative symptoms were alleviated.The rest pain disappeared,skin temperature significantly increased,ulcer healed with clear boundaries between the necrosis and the normal tissue in 25 cases.The rest 1 case was amputated in other hospital because of the postoperative thrombogenesis in the great saphenouse vein.The average ankle/brachial index（ABI） increased from 0.32 to 0.78.The cumulative patency rate at 6,12 and 24 months was 96.1%,88.5%,80.8%,respectively.Conclusion Application of in situ saphenous vein bypass according to the patients is an effective way to treat Fontaine Ⅲ、Ⅳ arteriosclerosis obliterans,especially those with severe symptoms of ischemia because of long-range,multi-segment,multi-planar stenosis or occlusion.

关 键 词：动脉硬化闭塞症 大隐静脉 原位 自体 血管外科手术 

分 类 号：R654.4[医药卫生—外科学]