腘动脉闭塞患者行开放手术重建的临床分析  

Clinical analysis of open surgical revascularization of popliteal artery occlusion

作　　者：杨根欢 廖鹏志 汪岩[1] 贾玉龙[1] Yang Genhuan;Liao Pengzhi;Wang Yan;Jia Yulong(Department of Vascular Surgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院血管外科,北京100070

出　　处：《血管与腔内血管外科杂志》2023年第7期777-780,共4页Journal of Vascular and Endovascular Surgery

基　　金：首都医科大学教育教学改革研究课题(2023JYY230)。

摘　　要：目的总结腘动脉闭塞患者行开放手术重建的策略和经验。方法收集2018年6月至2022年6月于首都医科大学附属北京天坛医院进行开放手术治疗的12例腘动脉闭塞患者的临床资料,分析不同病变情况的治疗策略及临床疗效。结果12例腘动脉闭塞患者的手术均顺利完成,其中,进行腘动脉P1段内膜剥脱术的患者3例,应用大隐静脉进行重建的患者6例,应用人工血管进行重建的患者3例。手术时间为120~210 min,中位160 min。术中出血量为50~200 ml,中位100 ml。术后踝肱指数(ABI)为0.66~1.04,中位0.85。随访时间为3~51个月,中位13.5个月。随访期间,2例患者发生人工血管桥闭塞,其余患者的桥血管或重建的腘动脉均通畅。结论腘动脉闭塞的病因多样,需根据不同的病变情况采取个体化的血管重建策略。Objective To summarize the strategy and experience of open surgical revascularization of popliteal artery occlusion.Method The clinical data of 12 patients with popliteal artery occlusion undergoing open surgery in Beijing Tiantan Hospital,Capital Medical University from June 2018 to June 2022 were collected,the treatment strategy and clinical efficacy of patients with different conditions were analyzed.Result All the 12 patients with popliteal artery occlusion were successfully operated,3 patients underwent endarterectomy of P1 segment of popliteal artery,6 patients underwent revascularization with great saphenous vein,and 3 patients underwent revascularization with artificial blood vessel.The operation time was 120 to 210 minutes,the median was 160 minutes.The intraoperative blood loss was 50 to 200 ml,the median was 100 ml.The ankle brachial index(ABI)after operation was 0.66 to 1.04,the median was 0.85.The patients were followed up for 3 to 51 months,the median was 13.5 months.During the follow up,the artificial vessel occlusion happened in 2 patients and other's bridging vessels or reconstructed popliteal arteries were unobstructed.Conclusion There are various causes of popliteal artery occlusion,and individualized revascularization strategies should be adopted according to different conditions.

关 键 词：腘动脉闭塞 腘动脉狭窄 开放手术 血管重建 

分 类 号：R543.5[医药卫生—心血管疾病]