摘要
目的 探讨下肢多节段动脉硬化闭塞症外科治疗的临床经验。 方法 术中行髂动脉腔内微创技术 (球囊扩张和支架植入 ) ,并同时行肢体远端动脉重建术治疗广泛多节段动脉硬化闭塞症 47例 ( 5 8条肢体 )。 结果 术中 5 3条髂动脉球囊扩张和支架植入均获成功 ,微创治疗技术成功率 10 0 % ;同时行远端动脉重建 5 8条肢体 ,其中包括 :股 -动脉人工血管旁路术 40条肢体 ;深动脉内膜剥脱或补片扩大成形术 18条肢体。股 -动脉人工血管旁路术后踝肱指数平均 0 .77± 0 .13 ( 0 .5～ 1.2 ) ,与术前相比有显著性差异 (P <0 .0 1)。股深动脉扩大成形术后踝肱指数 0 .41± 0 .15 ( 0 .2～ 0 .5 6) ,与术前相比有提高 (P <0 .0 5 )。死亡 1例 (占 2 .1% ) ,其余无严重并发症。平均随访 2 1( 3～ 42 )个月 ,髂动脉支架一期通畅率为 98.1% ( 5 1 5 2 ) ,二期通畅率为 10 0 % ( 5 2 5 2 ) ,股 -动脉人工血管一期通畅率为 87.2 % ( 3 4 3 9) ,二期通畅率为 94.9% ( 3 7 3 9)。截肢率 3 .4% ( 2 5 8)。 结论 术中髂动脉腔内微创介入治疗结合远端动脉重建术是治疗严重多节段动脉硬化闭塞症安全。
Objective To evaluate the preliminary clinical results of surgery for multilevel atherosclerotic occlusive disease of lower extremities. Methods From July 1999 to January 2003,intraluminal iliac mini-invasive approaches combined with simultaneous surgical procedures were performed on 58 lower extremities of 47 patients suffering from critical multilevel atherosclerotic occlusive disease. Results 53 iliac mini-invasive approaches combined with simultaneous 40 femoro-popliteal bypass and 18 profundaplasty were successfully performed. The success rate of mini-invasive approaches was 100%. The post-operative ABI of femoral-popliteal bypass and profundaplasty was 0.77±0.13(0.5～1.2)( P <0.01) and 0.41±0.15(0.2～0.56)( P <0.05) respectively.The postoperative mortality was 2.1%.The mean follow-up period was 21 months (range 3～42 months). The cumulative primary and secondary patency rate of stented iliac arteries was 98.1%(51/52) and 100%(52/52) respectively. And the primary and secondary patency rate of femoro-popliteal bypass grafts was 87.2% (34/39) and 94.9% (37/39) respectively.The amputation rate was 3.4%(2/58). Conclusion Intraluminal iliac artery mini-invasive approaches (PTA and stenting) can be safely and effectively performed simultaneously with the infrainguinal revascularization for multilevel atherosclerotic occlusive disease.
出处
《中国现代手术学杂志》
2003年第2期106-108,共3页
Chinese Journal of Modern Operative Surgery
关键词
多节段动脉硬化闭塞症
外科治疗
人工血管
血管外科手术
atherosclerotic occlusive disease
blood,vessel prothesis
stents
vascular surgical procedures
