下肢多平面动脉闭塞症的术式探讨  

Treatment of multi-level arterial occlusive disease of the lower extermities

作　　者：田路[1] 梅劲桦[2] 张纪蔚[2] 张柏根[2] 

机构地区：[1]浙江大学医学院附属第一医院血管外科,浙江杭州310003 [2]上海第二医科大学附属仁济医院血管外科,上海200001

出　　处：《外科理论与实践》2004年第1期43-45,共3页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨下肢多平面动脉闭塞症的动脉重建方式。方法:全组68例病人,男55例,女13例,平均71.2岁。近端动脉重建术37例(40条下肢,Ⅰ组),一期实施近、远端动脉重建术31例(32条下肢,Ⅱ组)。结果:两组病人的肢体缺血程度有明显差异(P<0.05),病变动脉的累及部位无明显差异。术后病死率分别为2.7%和3.2%,截肢率分别为7.5%和6.2%,均无差异。两组病人临床治疗效果有明显差异(P<0.05),但术后并发症和动脉累积通畅率上无明显差异。结论:下肢多平面动脉闭塞症根据个体化原则选择动脉重建方式,一期近、远端动脉重建术的症状完全缓解率较高,是治疗该症的主要手术方法。Objective To analyse and summarize the mode of surgical treatment of multilevel arterial occlusive di-sease (MLAOD) of the lower extremities. Methods From January 1998 to September 2002, 68 (72 limbs) patients with MLAOD were treated by different modes surgical procedures. Fifty-five patients were male, 13 were female,with an average age of 71.2. The patients were divided into two groups . GroupⅠ,37 patients (40 limbs) underwent isolated inflow operations only; group Ⅱ, 31 patients (32 limbs) underwent simultaneous inflow and outflow reconstruction. Results The 2 groups were significantly different in degrees of severity(P<0.05), but not significantly different in position of the disease (P>0.05). Both of the two groups, one patient died in each group(2.7% vs 3.2%) in the postoperative period, and the postoperative amputation rates were 7.5% and 6.25% respectively(P>0.05). Different clinical results were obtained in the 2 groups(P>0.05), even though there were no significant difference in postoperative complications and arterial bypass cumulative patency rate. Conclusions Surgical treatment of MLAOD should be individualized . Simultaneous inflow and outflow reconstruction provide complete relief of symptoms in a higher percentage of patients and remains the procedure of chice for MLAOD patients.

关 键 词：下肢多平面动脉闭塞症 手术方式 手术治疗 近端动脉重建术 远端动脉重建术 

分 类 号：R654.3[医药卫生—外科学]