腋-股动脉旁路术治疗主髂动脉闭塞性疾病的疗效分析

Department of Vascular Surgery,the First Affiliated Hospital of Dalian Medical University, Dalian 116011,China

关键词:  动脉闭塞性疾病  动脉旁路术  人工血管

Key words:  aorto-iliac occlusive diseases  vascular surgery  prosthetic blood vessel

摘要:

目的　探讨腋-股动脉旁路术在治疗主髂动脉闭塞性疾病中的意义。方法　回顾性分析采用腋-股动脉旁路术治疗的35例主髂动脉闭塞性疾病患者，其中有间歇性跛者5例，下肢静息痛11例，合并溃疡或坏疽19例。闭塞原因包括动脉硬化闭塞症29例、血栓形成5例、主动脉夹层1例。术式为腋-双股动脉旁路术19例，腋-单侧股动脉旁路术16例，使用的旁路移植血管均为聚四氟乙烯（Gore-Tex）人工血管。结果　本组病例围手术期未发生死亡，术后患肢间歇性跛行或静息痛消失，皮肤温度、颜色明显改善。远期随访时间3~80个月，总的术后1、3、5年移植血管的通畅率分别为：93%、87%、81%。 结论　腋-股动脉旁路术具有侵袭性小，疗效确切等特点，是治疗主髂动脉闭塞性疾病的有效方法之一。

Abstract:

Objective 〖WTBZ〗To study the role of axillofemoral arterial bypass in the management of aorta-iliac occlusive disease. 〖WTHZ〗Methods 〖WTBZ〗Thirty-five cases of aorta-iliac occlusive disease managed by axillofemoral arterial bypass were retrospectively analyzed. Diseases for occlusion include arteriosclerosis obliterans in 29 cases, thrombosis 5 cases and dissection 1 case, respectively. Clinical features include claudication in 5, resting pain 11 and ulcer/gangrene 19 patients, respectively. Axillo-bifemoral bypass was performed in 19 and axillo-unifemoral bypass 16 cases, respectively. 〖WTHZ〗Results 〖WTBZ〗Postoperatively, symptoms were relieved in all cases, with resting pain disappeared and skin temperature improved. Patients were followed up for 3 monthes to 80 monthes. The overall graft patency rates in this series were 93%, 87% and 81% in 1 year, 3 years and 5 years, respectively. 〖WTHZ〗Conclusion 〖WTBZ〗Axillofemoral arterial bypass has merits like less invasive and definite therapeutic effects, and thus is one of the effective methods for the treatment of aorta-iliac occlusive diseases.