下肢动脉粥样硬化闭塞症治疗的临床研究  

Clinical study on treatment for atheroscle rotic occlusion in lower limbs

作　　者：孙英信[1] 时德[1] 张依仁[1] 白麟祥[1] 刘象和[1] 

机构地区：[1]重庆医科大学附属第一医院普通外科,重庆400016

出　　处：《第三军医大学学报》2002年第4期467-469,共3页Journal of Third Military Medical University

摘　　要：目的　探讨下肢粥样动脉硬化闭塞症的治疗。方法　对 1980年 1月至 2 0 0 1年 10月 176例下肢粥样动脉硬化闭塞症的一般资料、药物治疗、手术方法及结果进行回顾性分析。结果　 14例Ⅱ期病人经药物治疗症状得到改善 ,41例Ⅲ期病人症状有一定改善 ,73例Ⅳ期患者无明显效果。 3 8例大隐静脉动脉化术后未发生截肢者 ;3 6例腰交感神经节切除后 8例 1～ 3年再次截肢。 1例人造血管移植 1年后发生栓塞 ;1例经患肢穿刺造影术后整个肢体发生急速严重缺血后因多器官功能衰竭死亡。结论　Ⅱ期病人以药物治疗为主 ,Ⅲ、Ⅳ期病人术后应坚持药物治疗 ,截肢平面应根据残端供血情况适当提高 ,以免残端缺血再次手术。Objective To study the treatment for atherosclertic occlusion in lower limbs. Methods The general data, drug treatments, surgical methods and results of 176 patients with atherosclerotic occlusion in lower limbs from January 1980 to October 2001 in our hospital were retrospectively analyzed. Results After drug therapy, symptoms were obviously alleviated in 14 cases at stageⅡ, somewhat alleviated in 41 cases at stage Ⅱ, and no effect in 73 cases at stage Ⅳ. Thirty eight cases with arteriolization of great saphenous vein did not suffer from amputation after the operation. Of 36 cases with lumbar sympathectomy, 8 were reamputated in 1 to 3 years after operation. Embolism occurred 1 year later in 1 case with artificial vascular transplantation. One patient died from acute severe ischemia and multiple organ failure after contrast examination through puncturing the lesion limbs. Conclusion Patients at stageⅡshould be treated mainly with drug therapy. Drug therapy should be continued for those patients at stage Ⅲ and Ⅳ after operation. The amputation plane should be appropriately raised according to the blood supply conditions of the stump, in case of re-operation caused by the stump ischemia.

关 键 词：下肢动脉粥样硬化闭塞症 治疗 诊断 

分 类 号：R654.4[医药卫生—外科学]