远程内膜剥脱术治疗复杂型下肢动脉缺血病变的有效性分析  

Remote endarterectomy for complex lower extremity ischemia

作　　者：王吉阳[1] 陈作观 刁永鹏[1] 李鹏[1] 谭树平[1] 兰勇[1] 鲁城然 李拥军[1] Wang Jiyang;Chen Zuoguan;Diao Yongpeng;Li Peng;Tan Shuping;Lan Yong;Lu Chengran;Li Yongjun(Department of Vascular Surgery,Beijing Hospital,National Center of Gerontology/Institute of Geriatric Medicine/Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院国家老年医学中心中国医学科学院老年医学研究院血管外科,100730

出　　处：《中华普通外科杂志》2021年第12期926-930,共5页Chinese Journal of General Surgery

基　　金：中国医学科学院医学与健康科技创新工程重大协同创新项目(CIFMS. 2018-I2M-1-002)。

摘　　要：目的探讨远程内膜剥脱术在复杂型下肢动脉缺血病变治疗中的治疗效果。方法回顾性分析2016年9月至2020年2月期间本中心收治的21例复杂型下肢动脉闭塞行远程内膜剥脱术的患者的临床资料。计算通畅率及评估整体保肢率,并与中转人工血管搭桥组进行对比。结果 21例患者均行单侧下肢动脉远程内膜剥脱术,手术成功15例,技术成功率71.4%(15/21)。因血管损伤行覆膜支架置入2例。6例患者中转人工血管旁路手术。远程内膜剥脱组术后3、6、12个月的一期通畅率分别为93.3%、85.6%和74.1%。术后1年保肢率为93.3%。人工血管旁路术一期通畅率术后3、6、12个月分别为76.7%、66.7%、46.8%。术后1年保肢率为66.7%。结论下肢动脉远程内膜剥脱术是治疗复杂型下肢动脉缺血病变的有效方式之一,可做为选择行人工血管旁路手术之前的优选方案。Objective To evaluate the effect of remote endarterectomy in the treatment of complex lower extremity ischemia.Methods Twenty-one limb ischemic patients underwent remote endarterectomy in Beijing Hospital from Sep 2016 to Feb 2020.Clinical data including general condition,the lesion of lower artery before operation and follow up outcomes were collected.Then the patency rate and limb salvage rate were calculated.Results The technique success rate was 71.4%(15/21).The 3,6,12 month patency rate were 93.3%,85.6%and 74.1%,respectively.The 1-year limb salvage rate was 93.3%(14/15).In the 6 patients converted to artificial vessel bypass,the 3,6,12 months patency rates were 76.7%,66.7%and 46.8%,respectively.The 1-year limb salvage rate was 66.7%.Conclusions Remote endarterectomy of the lower extremity artery is an alternative option in the treatment of complex ischemic lesions of the lower extremity artery,other than artificial vessel bypass.

关 键 词：动脉闭塞性疾病 动脉内膜切除术 人工血管旁路手术 复合手术 

分 类 号：R654.4[医药卫生—外科学]