摘要
目的探讨介入技术和外科手术在大动脉炎治疗中的应用。方法2006年1月至2009年12月共收治大动脉炎26例，男女比例为1：4．2，平均年龄（27±15）岁；Lupi—Here法分型，Ⅰ型16例，Ⅱ型7例，Ⅲ型3例。16例患者实施介入治疗，9例行开放手术，1例患者保守治疗。结果16例患者实施介入治疗23次，其中12例患者行单纯球囊成形治疗，4例患者接受血管支架治疗。5例颈动脉单侧重度狭窄局部闭塞患者中4例再通。1例颈动脉球囊成形后急性血栓形成，4例患者接受反复介入治疗共11次，血管维持通畅。9例患者开胸旁路搭桥手术，围手术期全部患者症状缓解。本组26例，随访22例。随访时间12～46个月，平均（34±11）个月。1例患者术后3个月因脑出血死亡，1例术后24个月发现吻合口假性动脉瘤，2例吻合口狭窄。结论大动脉炎介入治疗安全性高，可反复应用，能维持血管通畅，应首选；外科开放手术难度高，应用于介入治疗无效或重症患者时效果确切。
Objective To evaluate vascular surgery and interventional technique applied in Takayasu＇s arteritis. Methods Data of 26 patients of Takayasu＇s arteritis admitted between January 2006 and December 2009 were retrospectively analyzed. The sex ratio （M/F） was 1： 4. 2, age averaged at （27±15）y. There were 16 cases of type Ⅰ , 7 cases of type Ⅱ and 3 cases of type Ⅲ according to Lupi-Herrera classification. 25 patients received surgery including 16 patients undergoing pecutaneous transluminal angioplasty operations, 9 patients doing traditional bypass surgery, and one patient was treated conservatively. Results 23 case-times of percutaneous transluminal angioplasty （PTA） were performed in 16 patients, including 12 cases of balloon angioplasty and 4 cases of stent angioplasty. Four significantly stenotie and occluded carotid arteries were revascularized successfully in 5 patients. Thrombosis of the carotid artery was found in one patient after balloon angioplasty. There were 4 patients in which repeated PTA treatment up to a total of 11 times were needed to guarantee vessel patency. Open surgery succeeded in 9 patients, and clinical symptoms were relieved in all cases during peri-operative period. 22 patients were followed up for 12 -46 months ,one patient died of cerebral hemorrhage 3 months post-operation, one patient was found pseudoaneurysm at anastomotic stoma, and 2 patients suffered from anastomotic restenosis. Conclusions Vascular surgery played important role in the therapy of Takayasu＇s arteritis. PTA can be used repeatedly. Surgical bypass operation is difficult in technology, and can be used in cases that fail to response to PTA or in patients with severe cerebral ischemia.
出处
《中华普通外科杂志》
CSCD
北大核心
2011年第8期664-667,共4页
Chinese Journal of General Surgery
