腘动脉瘤外科治疗25例  

Surgical treatment of popliteal aneurysms in 25 patients

作　　者：胡海地[1] 刘翀[2] 常青[1] 任延英[1] 蔡永昌[1] 段志泉[1] 张健[1] 辛世杰[1] 

机构地区：[1]中国医科大学附属第一医院血管甲状腺外科,沈阳110001 [2]中国医科大学盛京医院外科,沈阳110001

出　　处：《中华普通外科杂志》2012年第12期985-987,共3页Chinese Journal of General Surgery

基　　金：国家自然科学基金资助项目（30200276）

摘　　要：目的总结胭动脉瘤的外科诊治经验。方法回顾性分析1988年1月至2012年1月间25例胭动脉瘤患者的临床资料，其中男21例，女4例，年龄13～72岁，平均（56±16）岁。病因为动脉粥样硬化18例，外伤6例，胭动脉陷迫综合征1例。本组症状主要为胭窝部搏动性肿物、患肢疼痛、急慢性远端缺血、患肢肿胀等。结果25例患者中23例行手术治疗，其中17例行动脉瘤切除、自体大隐静脉移植术，4例行动脉瘤切除、人工血管移植术，1例行动脉瘤结扎术，1例行动脉瘤切除、对端吻合术。23例手术患者围手术期无死亡，1例患者术后第45天发生吻合口血栓形成，导致远端缺血坏死行膝上截肢术。术后21例（84％）获得随访，平均随访（6．5±0．5）年，1例双侧胭动脉瘤术后4年又发现右锁骨下动脉瘤，手术成功切除。另2例保守治疗。结论胭动脉瘤可发生破裂或肢体远端缺血，积极手术治疗可获得良好治疗效果，并需加强术后随访。Objective To evaluate surgical therapies in patients with popliteal aneurysms （PA）. Method The clinical data of 25 PA patients admitted from January 1988 to January 2012 were retrospectively analyzed. There were 21 men and 4 women, the mean age was （56 ± 16）years. There were 27 PA in these 25 patients, with bilateral PA in 2 cases. The main symptoms were pulsatile mass in the popliteal fossa,limb pain, acute or chronic distal limb ischemia and limb edema. Result In this series 23 out of 25 PA cases recieved operations, 17 of them were treated with aneurysmectomy and saphenous vein interposition or bypass grafting, 4 of them were treated with aneurysmectomy and prosthetic grafts interposition, 1 was treated with aneurysm ligation and 1 underwent end-to-end anastomosis after aneurysm resection. There was no perioperative mortality. One patient recieved amputation for distal anastomotic thrombosis and severe limb ischemia. The mean follow-up time is （6. 5 ± 0.5） years. After 4 years, a right subclavian artery aneurysm was found in a bilateral PA case and treated surgically. Conclusions Early elective surgical treatment is recommended for patients with PA because PA may go rupture or induce dital limb ischemia and these patients may have good outcome after surgical treatment. Long-term follow-up is warranted to detect the new aneurysm formation.

关 键 词：动脉瘤 血管外科手术 诊断 

分 类 号：R654.3[医药卫生—外科学]