青少年腘动脉陷迫综合征17例诊疗分析  

Diagnosis and treatment of adolescent popliteal artery entrapment syndrome：a report of 17 cases

作　　者：张精勇[1] 王茂华[1] 金星[1] 吴学君[1] 种振岳[1] 张十一[1] 

机构地区：[1]山东大学附属省立医院血管外科,济南250021

出　　处：《临床外科杂志》2014年第1期43-46,共4页Journal of Clinical Surgery

基　　金：高等学校博士学科点专项科研基金（20090131110059）、山东省自然科学基金（ZR2012HM063）

摘　　要：目的 总结青少年腘动脉陷迫综合征（popliteal artery entrapment syndrome,PAES）的影像学诊断与手术治疗经验.方法 对17 例（18 条下肢）青少年PAES 患者术前施行了超声多普勒,CTA或MR检查,并对17条患肢施行了相应的手术治疗,监测手术前后患肢踝肱指数（ankle brachial index,ABI）变化.13 条患肢施行了腘动脉周围异常组织松解术,其中5条因动脉闭塞同时施行了大隐静脉旁路移植术,4条患肢因动脉内膜增厚实行腘动脉内膜切除＋动脉成形术;4条肢体行自体大隐静脉移植术.结果 16例患者随访 6个月～6年,平均（30.88±19.88）个月,所有手术肢体间歇性跛行症状治愈,踝肱指数由术前的（0.47±0.09）上升至术后的（0.96±0.07）,较术前显著提高（P＜0.01）.1例患者因肺动脉栓塞术后1d死亡.结论 PAES是青少年下肢动脉缺血的一个重要病因.影像学诊断是确诊本病的重要手段,早期积极外科干预预后较好.Objective To summarize the experience of imaging diagnosis and surgical treatment in 17 cases of adolescent popliteal artery entrapment syndrome（PAES）. Methods A total of 17 PAES pa- tients（ 18 limbS）were preoperatively examined with Doppler ultrasound, CTA and MR, and 17 limbs were treated with surgery. Changes of ankle brachial index（ABI） were monitored before and after operation. Ly- sis of abnormal tissues around the popliteal artery was performed in 13 limbs, including 5 limbs of com- bined bypass grafting of great saphenous vein due to artery occlusion,4 limbs of combined endarterectomy and artery autoplasty due to thickened arterial walls, and 4 limbs of autogenous great saphenous vein graft- ing. Results The follow-up period ranged from 6 months to 6 years,with an average of（30.88 ＋ 19.88） months. Symptom of intermittent claudication was disappeared in 16 cases, and the ABI significantly ascen- ded from（0.47 ＋0.09）to（0.96 ＋0.07） （P 〈0.01 ）. One case died from pulmonary embolism at the first day after surgery. Conclusion PAES is a major cause of lower limb ischemia in adolescents. Imaging di- agnosis is an important diagnostic measure, and early aggressive surgical therapy has positive effects on prognosis.

关 键 词：腘动脉陷迫综合征 诊断 手术治疗 

分 类 号：R654.4[医药卫生—外科学]