腘动脉陷迫综合征误诊分析  

Analysis of Misdiagnosis of Popliteal Artery Entrapment Syndrome

作　　者：石波 李志娟 张雪原 李天天 庄百溪[1] SHI Bo;LI Zhijuan;ZHANG Xueyuan;LI Tiantian;ZHUANG Baixi(Department of Peripheral Vascular Diseases,Xiyuan Hospital of Chinese Academy of Traditional Chinese Medicine,Beijing 100091,China)

机构地区：[1]中国中医科学院西苑医院周围血管病科,北京100091

出　　处：《临床误诊误治》2023年第5期6-10,共5页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨腘动脉陷迫综合征(PAES)误诊原因,提高对该病的认识。方法回顾性分析2017年12月—2021年12月曾误诊的4例PAES的临床资料。结果本组3例因下肢发凉及间歇性跛行就诊,经查体及相关医技检查,其中2例误诊为血栓闭塞性脉管炎,1例误诊为腘动脉硬化闭塞合并血栓形成。1例因腘窝搏动性包块就诊,经查体及相关医技检查,误诊为腘动脉瘤。经详细体格检查,完善MRI及下肢动脉造影后4例均确诊为PAES。4例皆行异位肌腱离断松解及腘动脉血运重建术,术后恢复良好,随访3~24个月血管通畅。结论PAES临床少见,表现无特异性,容易误诊。提高接诊医生对PAES解剖结构异常、影像学特点和临床表现的认识,是避免误诊的关键。Objective To explore the causes of misdiagnosis of popliteal artery entrapment syndrome(PAES)and to improve the understanding of this disease.Methods The clinical data of 4 patients with PAES who were misdiagnosed from December 2017 to December 2021 were retrospectively analyzed.Results In this study,3 cases were treated for lower limb coolness and intermittent claudication.After physical examination and relevant medical technical examination,2 cases were misdiagnosed as thromboangiitis obliterans,and 1 case was misdiagnosed as popliteal arteriosclerosis occlusion complicated with thrombosis.One case was misdiagnosed as popliteal aneurysm due to pulsive mass in popliteal fossa after physical exami⁃nation and related technical examination.After detailed physical examination,improved MRI and lower extremity arteriogra⁃phy,all the 4 cases were diagnosed as PAES.All the 4 cases underwent ectopic tendon dissection and popliteal arterial revascularization.The postoperative recovery was good,and the patency of blood vessels was found after 3⁃24 months of follow⁃up.Conclusion PAES is rare in clinical practice,and the manifestations are not specific,which,therefore,is more likely to cause misdiagnosis.The key to avoid misdiagnosis is to improve the understanding of the doctors to the anatomical abnormali⁃ties,imaging features and clinical manifestations of PAES.

关 键 词：腘动脉陷迫综合征 误诊 血栓闭塞性脉管炎 动脉硬化 腘动脉瘤 血栓形成 踝-肱指数 间歇性跛行 

分 类 号：R543.5[医药卫生—心血管疾病]