摘要
目的探讨手术治疗头臂型大动脉炎所导致的严重脑缺血的疗效和经验。方法15例重症头臂型大动脉炎患者经胸行人工血管旁路术，升主动脉-双腋动脉、单颈内动脉（ICA）架桥6例，升主动脉-双腋动脉架桥3例，升主动脉一单腋动脉、单ICA架桥5例，1例合并腹主动脉闭塞的复合型，一期行升主动脉-双腋动脉、单ICA架桥，二期行单侧腋股搭桥术。结果经胸行人工血管旁路术可明显改善头臂型大动脉炎所导致的严重脑缺血症状。15例手术患者无一例死亡，术后随访3～40个月，患者均无明显脑缺血症状复发，并能正常地工作、生活。结论重症头臂型大动脉炎的患者如果出现严重的脑缺血症状，急性期如果激素治疗无效，或在非活动期，都应积极行人工血管旁路术。该手术不仅疗效确切，能迅速缓解症状，挽救患者的生命，预防失明和偏瘫；而且远期疗效肯定，辅以长期的药物治疗，能够达到治愈的效果。
Objective To evaluate the effect of surgical treatment to Takayasu＇s arteritis with severe cerebral ischemia. Methods Arterial bypass with prosthesis - graft was carried out in 15 cases： ascending aorta- bilateral axillar arteries and unilateral ICA bypass in 6 cases, ascending aorta - bilateral axillar arteries bypass in 3 cases, ascending aorta - unilateral axillar arteries and unilateral ICA bypass in 5 cases, and in one case of complicated TA combined with abdominal aorta, ascending aorta- bilateral axillar arteries and unilateral ICA bypass were performed, followed by unilateral axilla - femeral bypass. Results All the cases treated with above- mentioned methods had obviously released the symptoms of severe cerebral ischemia caused by TA. None of the 15 eases was dead after operation. After follow- up for 3 - 50 months, there was no recurrence of the cerebral ischernia, Conclusion If patients with TA suffered severe cerebral ischemia, without efficacy by treatment of hydrocortisone in active phase,or in the inactive phase,arterial bypass with prosthesis- graft is strongly recommended. The result of the methods is definitive and effective, and it can save the life of the patients and avoid blindness and hemiplegia. The long- term effect is positive, and combined with medical treatment, it can reach the result of complete heal from TA.
出处
《临床外科杂志》
2007年第10期687-689,共3页
Journal of Clinical Surgery
关键词
大动脉炎
脑缺血
血管旁路术
takayasu＇ s arteritis
cerebral ischemic syndromes
bypass operation
