摘要
目的探讨股腘动脉旁路移植术治疗下肢动脉硬化闭塞症（C、D级病变）的近中期疗效。方法2005年1月至2009年2月，170例患者（191条肢体）行股动脉以远血管重建术。其中男性108例，女性62例；年龄45—85岁，平均67岁。症状包括间歇性跛行78例，静息痛62例，下肢缺血性溃疡19例，远端组织坏死11例。所有患者术前均行动脉造影检查，根据TASC11分级：C级病变127条肢体，D级病变64条肢体。手术方法包括大隐静脉原位旁路移植术15条肢体，大隐静脉转位20条肢体，人工血管旁路移植术128条肢体，大隐静脉与人工血管组合旁路移植术28条肢体。结果围手术期无死亡病例。术后随访6～36个月，平均（24±6）个月；76例失访，随访率57％（109／191）。一期通畅率84．4％（92／109），其中人工血管旁路移植通畅率88．2％（75／85），大隐静脉（原位、转位、组合）旁路移植通畅率70．8％（17／24）。二期通畅率89．9％（98／109）。结论人工血管旁路移植术是治疗严重股胭动脉闭塞症（TASCC和D级病变）的主要方法，手术疗效满意。
Objective To explore the mid-term surgical results of arterial revascularization for femoro-popliteal arterial occlusive disease （lesion type C and D ） . Methods From January 2005 to February 2009,191 arterial bypass had been performed on 170 patients （21 cases bilateral）. There were 108 male and 62 female, age ranged from 45 to 85 years old with an average of 67 years old. The operative indication was claudication in 78 cases, rest pain in 62 cases, ischemic ulcer in 19 cases, and distal tissue necrosis in 11 cases. Arterial angiography were performed on all cases. According to TASC II document, type C lesions were seen in 127 limbs, type D lesions were seen in 64 limbs. Autogenous greater saphenous vein bypass in situ were done on 15 limbs, autogenous greater saphenous vein bypass reversed in 20 limbs, revascularization with artificial prosthesis in 128 limbs, composite grafts consisting of a prosthetic conduit with a distal venous segment in 28 limbs. Results There were no 30-day mortality. Follow-up periods ranged 6 to 36 months with an average of （24 ± 6） months. Seventy-three cases were lost during follow-up periods, follow-up rate was 57% （109/191）. Primary patency rate was 84. 4% （92/109）. The patency rate was 88.2% with artificial prothesis, 70. 8% with greater saphenous vein （in situ or reversed）. Secondary patency rate was 89. 9%. Condusions Arterial revascularization with artificial prosthesis is main treatment for diffused superficial femoral artery occlusive disease （TASC II type C and D lesion ） with satisfied surgical results.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2010年第4期268-270,共3页
Chinese Journal of Surgery
关键词
动脉硬化
闭塞性
血管外科手术
股动脉
腘动脉
Arteriosclerosis obliterans
Vascular surgical procedures
Femoral artery
Popliteal artery
