摘要
目的 评价股-股深动脉人工血管移植旁路术治疗单侧髂股动脉长段硬化闭塞症的长期疗效.方法 回顾性分析1995年7月至2010年12月收治的40例单侧长段髂股动脉硬化闭塞症患者的临床资料,其中男28例,女12例；年龄66 ～ 90岁,平均（73±6）岁.所有患者的诊断经CT动脉造影证实,单侧髂总动脉,髂外动脉,股总动脉和股浅动脉硬化闭塞.均采用股-股深动脉人工血管旁路术治疗,术前、后检测血管流速,踝/肱指数.使用Kaplan-Meier方法分析5、7、10年累积通畅率和5、7、10年保肢率.结果 本组患者在围手术期无死亡和截肢.35例（87.5％）随访1 ～13年,平均（5.7±2.8）年.ABI由术前平均0.23±0.10升至术后0.55±0.11,差异有统计学意义（t=15.91,P=0.000）.术前彩超检测腘动脉及胫动脉平均血流速度分别为（14±6）cm/s和（10±4） cm/s,术后分别升至（34±10）cm/s和（22±7）cm/s.术后5、7、10年一二期累计通畅率分别为：60.1％,44.3％,25.3％和93.5％,86.8％,57.9％.术后5,7,10年保肢率分别为：97.5％,95％和90％.结论 治疗单侧髂股动脉长段闭塞症,股-股深人工血管旁路术安全有效,本术式可用于不适合腔内治疗和开腹手术的患者.
Objective To evaluate the clinical results of femoral-deep femoral crossover bypass in the treatment of long-segment unilateral iliac artery occlusive disease.Methods From July 1995 to December 2010,40 patients （28 males,12 females,aged from 66 to 90,with mean age of 73） with comprehensive unilateral iliac-superficial femoral arteriosclerosis obliterans were enrolled in this procedure.All patients suffered from unilateral common iliac,external iliac,common femoral,and superficial femoral arteriosclerosis obliterans.These patients were treated with femoral-deep femoral crossover bypass.Postoperative ankle-brachial index,blood flow velocity and patency rates in 5,7 and 10 years and limb salvage rates in 5,7 and 10 years were evaluated.Results There was no perioperative mortality nor extremity amputation.35 （87.5% ） patients were followed-up from 1 to 13 years （mean 5.7 y）.Anklebrachial index rose from preoperative 0.23 ± 0.10 to postoperative 0.55 ± 0.11 （t =15.91,P =0.000 ）.Popliteal arterial velocity rose from preoperative （ 14 ±6） cm/s to postoperative （34 ± 10） cm/s （t =15.63,P =0.000） ; Tibial arterial velocity rose from （ 10 ±4） cm/s to （22 ±7） cm/s （t =15.71,P =0.000）.The primary and secondary patency rates were 60.1%,44.3%,25.3%,and 93.5%,86.8%,57.9% at 5,7 and 10 years,respectively.Limb salvage rates were 97.5%,95%,and 90%,at 5,7 and 10 years,respectively.Conclusions Femoral-deep femoral crossover bypass is safe and reliable in treating certain unilateral iliofemoral occlusive disease,especially for high-risk old patients or those who are not indicated for endovascular therapies or direct aortic approaches.
出处
《中华普通外科杂志》
CSCD
北大核心
2012年第11期893-895,共3页
Chinese Journal of General Surgery
关键词
动脉闭塞性疾病
血管外科手术
人工血管
解剖外途径旁路术
Arterial occlusive＇diseases
Vascular surgical procedures
Blood vessel prosthesis
Extra-anatomic bypass
