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下肢多平面动脉闭塞症的术式探讨

Treatment of multi-level arterial occlusive disease of the lower extermities

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【作者】 田路梅劲桦张纪蔚张柏根

【Author】 TIAN Lu, MEI Jing-hua, ZHANG Ji-wei, ZHAMG Bai-gen. 1Department of Vascular Surgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003; 2Department of Vascular Surgery, Renji Hospital, Shanghai Second Medical University, Shanghai 200001, China

【机构】 浙江大学医学院附属第一医院血管外科上海第二医科大学附属仁济医院血管外科上海第二医科大学附属仁济医院血管外科 浙江杭州310003上海200001上海200001

【摘要】 目的:探讨下肢多平面动脉闭塞症的动脉重建方式。方法:全组68例病人,男55例,女13例,平均71.2岁。近端动脉重建术37例(40条下肢,Ⅰ组),一期实施近、远端动脉重建术31例(32条下肢,Ⅱ组)。结果:两组病人的肢体缺血程度有明显差异(P<0.05),病变动脉的累及部位无明显差异。术后病死率分别为2.7%和3.2%,截肢率分别为7.5%和6.2%,均无差异。两组病人临床治疗效果有明显差异(P<0.05),但术后并发症和动脉累积通畅率上无明显差异。结论:下肢多平面动脉闭塞症根据个体化原则选择动脉重建方式,一期近、远端动脉重建术的症状完全缓解率较高,是治疗该症的主要手术方法。

【Abstract】 Objective To analyse and summarize the mode of surgical treatment of multilevel arterial occlusive di-sease (MLAOD) of the lower extremities. Methods From January 1998 to September 2002, 68 (72 limbs) patients with MLAOD were treated by different modes surgical procedures. Fifty-five patients were male, 13 were female,with an average age of 71.2. The patients were divided into two groups . GroupⅠ,37 patients (40 limbs) underwent isolated inflow operations only; group Ⅱ, 31 patients (32 limbs) underwent simultaneous inflow and outflow reconstruction. Results The 2 groups were significantly different in degrees of severity(P<0.05), but not significantly different in position of the disease (P>0.05). Both of the two groups, one patient died in each group(2.7% vs 3.2%) in the postoperative period, and the postoperative amputation rates were 7.5% and 6.25% respectively(P>0.05). Different clinical results were obtained in the 2 groups(P>0.05), even though there were no significant difference in postoperative complications and arterial bypass cumulative patency rate. Conclusions Surgical treatment of MLAOD should be individualized . Simultaneous inflow and outflow reconstruction provide complete relief of symptoms in a higher percentage of patients and remains the procedure of chice for MLAOD patients.

  • 【文献出处】 外科理论与实践 ,Journal of Surgery Concepts & Practice , 编辑部邮箱 ,2004年01期
  • 【分类号】R654.3
  • 【下载频次】21
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