摘要
目的 探讨动脉内膜剥脱术治疗下肢缺血性疾病。 方法 本组 2 2例动脉闭塞症患者 ,术中在动脉闭塞远端纵行切开动脉 ,剥离切口处的动脉内膜后横断 ,将动脉内膜断端套入自制的不锈钢圈套器内 ,将圈套器向近端推进至闭塞近端 ,退出圈套器 ,用Fogarty取栓管取出动脉内膜 ,切口处缝合固定远端内膜断端。 结果 内膜剥脱长度 10～ 43cm ,19例症状完全消失 (86 4% ) ,1例股浅动脉内膜剥脱失败而改行自体大隐静脉倒置搭桥术 ,2例因流出道不良恶化而截肢 ,近期通畅率86 4%。无手术死亡。平均随访时间 3 2年 ,2例因动脉血栓形成行导管溶栓术后痊愈 ,2例切口狭窄闭塞 ,再次行切口成形术后痊愈。 1例则因血栓闭塞性脉管炎复发闭塞 ,出现静息痛 ,远期通畅率6 8 2 %。 结论 动脉内膜剥脱术仍是治疗下肢缺血性疾病的一种好方法 ,操作简单 ,医疗费用低廉 ,近期通畅率与动脉搭桥术相仿。
Objective To treat ischemia of th e lower extremity, endarterectomy was performed. Methods[WT 5”BZ] In 22 patients with arterial occlusive disease, arteriotomy was perf ormed at the distal end of the occlusive part. Artheroma was freed and cut off. A ring stripper was inserted into the artery and went up to the proximal end of the occlusive lesion. The artheroma was removed by a Fogarty through arteriotomy . The distal end of the cut intima was sutured to the arterial wall. [WT5” HZ]Results The removed occlusive lesion was 10 to 43 cm lon g. Symptoms disappeared in 19 patients (86 4%), and no deaths occurred. Endarte rectomy failed in one patient and a bypass was performed with the reversed suphe nous vein. Amputation was performed in two patients because of its insufficient run off. The average time of follow up was 3 2 years, and patients with arteri al thrombosis were treated by thrombolytic therapy. Two patients with artery ste nosis were cared by vein patch angioplasty. One experienced rest pain after trea tment with a long term patency 68 2%. Conclusions[WT5”B Z] Endarterectomy is still a choice of treatment for ischemia of the lower ex tremity, and it is simple and its patency is similar to that of arterial bypass.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2001年第5期347-348,共2页
Chinese Journal of Surgery
