摘要
目的总结股深动脉血流重建治疗下肢动脉硬化闭塞症的经验。方法选择FontaineⅢ、Ⅳ期下肢动脉硬化闭塞症共23例。入选标准:膝上无理想的用于旁路术的流出道,股深动脉主干长度达到或超过股骨干中点且与腘动脉间有侧支血管,近端动脉病变导致股深动脉内无正常动脉血流。采用旁路术、取栓术及股深动脉成形术重建股深动脉血流。结果全部FontaineⅢ期病例于术后肢体静息痛消失;9例FontaineⅣ期病例中术后肢体静息痛消失7例,6例于术后10 d行截足(趾)术,1例于术后1周行膝上截肢术。手术后踝/肱血压指数显著增加(P<0．01)。术后22例随访2个月至6年,移植血管3年通畅率为82％。结论股深动脉血流重建治疗严重肢体缺血简单、安全、有效。
Objective To evaluate profunda femoris revascularization for the treatment of arteriosclerosis obliterans of the lower extremity. Methods Twenty-three Fontaine＇s phase Ⅲ and Ⅳ patients underwent profunda femoris revascularization （bypass graft, embolectomy, profundoplasty）. All those patients fulfilled the selection criteria： No suitable outflow vessel conduit above the knee. Satisfactory femo-popliteal collateral system and distal profunda femoris exceeded the midpoint of the femur. Inadequate profunda femoris arterial inflow due to lesions of proximal artery. Results Rest pain subsided in all of phase Ⅲ patients and seven out of nine phase Ⅳ cases. Six patients with gangrene underwent minor amputations（ transphalangeal, transmetatarsal） and one above knee amputation. The ankle brachial systolic pressure index（ABI） in phase IU patients increased from 0. 28 ±0. 15 to 0. 67 ±0. 23 （P 〈0. 01 ） , ABI of patients with stage Ⅳ and from 0. 10 ±0. 08 to 0. 46 ±0. 22 in phase Ⅳ cases （P 〈 0. 01 ）. Postoperative 22 cases were followed-up from 2 months to 6 years. The patency rate of grafts was 82% at 3 years. Conclusions Profunda femoris revascularization is simple, safe and effective.
出处
《中华普通外科杂志》
CSCD
北大核心
2006年第7期488-490,共3页
Chinese Journal of General Surgery
关键词
动脉硬化
闭塞性
血管外科手术
血管重建
Arteriosclerosis obliterans
Vascular surgical procedures
Revascularization
