摘要
目的探讨腘动脉内膜剥脱术对以腘动脉闭塞为主的下肢血栓闭塞性脉管炎(TAO)的治疗效果。方法回顾性分析2000年9月至2008年11月接受腘动脉内膜剥脱手术的63例(67条下肢)TAO患者的临床资料。结果 65条患肢获得手术成功,成功率为97%(65/67)。患者术后次日、术后6个月的踝肱指数(ABI)分别为0.75±0.10与0.67±0.11,与术前(0.31±0.08)相比,差异有统计学意义(P<0.05)。无围手术期死亡病例。47例患者获得随访,随访率为77%(47/61);随访时间6～99个月,平均随访17个月。术后6个月动脉通畅率为85.7%(42/49),术后1年通畅率为73.4%(36/49);术后1年保肢率为95.9%(47/49)。2例分别在术后5个月及11个月因动脉再闭塞引起症状复发行截肢术。结论腘动脉内膜剥脱术对以腘动脉闭塞为主的下肢TAO具有较好效果,风险相对较低,远期通畅率较高。
Objective To investigate the treatment effects of sequential procedure stripping organized thrombus for lower extremities with thromboangitis obliterans(TAO),which mainly exists in popliteal artery.Methods Clinical data of 63 TAO cases(67 limbs) receiving sequential procedure stripping organized thrombus from September 2000 to November 2008 were retrospectively analyzed.The indications,clinical effect,complications,perioperative mortality,vascular patency and limb salvage rate of this procedure were evaluated.Results The technical success rate was 97%(65/67).Ankle-brachial index(ABI) increased to(0.75±0.10) and(0.67±0.11) at 2-day and 6-month postioperatively,respectively,which were significantly different from preoperative ABI(0.31±0.08)(P<0.05).No patient died in perioperative period.Forty-seven patients(77%) were followed up(6-99 months,mean 17 months).Accumulated primary vascular patency rate were 85.7%(42/49) and 73.4%(36/49) at 6-month,12-month postoperatively,respectively.Limb salvage rate at 1-year postoperatively was 95.9%(47/49).Two patients underwent amputation because of arteries re-occlusion at 5-month and 11-month postoperatively,respectively.Conclusion Sequential procedure stripping organized thrombus was the effective way for TAO,especially to occlusion of popliteal artery,due to lower risk and higher long-term patency.
出处
《中国血管外科杂志（电子版）》
2009年第2期113-115,共3页
Chinese Journal of Vascular Surgery(Electronic Version)
关键词
机化血栓剥脱术
血栓性脉管炎
闭塞性
腘动脉闭塞
血管通畅率
Stripping organized thrombus
Thromboangitis obliterans
Occlusion of popliteal artery
Vascular patency rate
