主髂动脉硬化闭塞症的外科治疗

Surgical treatment of aortoiliac occlusive disease

目的回顾性总结主髂动脉硬化闭塞症的外科治疗方式和效果。方法 2001年1月至2008年12月中山大学附属第一医院血管外科对68例主髂动脉硬化闭塞症患者施行外科手术治疗,其中57例采用解剖性旁路手术,11例采用解剖外旁路术。结果死亡1例,术后出现并发症4例,其中1例结肠坏死,切除坏死肠段并结肠造瘘后治愈;2例合并呼吸功能障碍;1例合并腹股沟切口淋巴漏。其余63例均取得良好效果。结论主-股(双股)动脉旁路术是治疗主髂动脉硬化闭塞症的主要方式,对于下肢缺血患者必要时行序贯性旁路术。

Objective To investigate surgical treatment of aortoiliac occlusive disease retrospectively.Methods From Jan,2001 to Dec,2008,68 cases with aortoiliac occlusive disease underwent operations,including anatomic bypasses(n=57) and extra-anatomic bypasses(n=11).Results One patient died and 4 cases occurred complications.Of these 4,there were 1 case of colon necrosis,2 case of respiratory dysfunction and 1 case of the groin lymphatic leak.The other 63 cases have got good results,and their ischemic symptoms recovered.Conclusion Aortobifemoral or aortofemoral bypass is the main surgical manner in the treatment of aortoiliac occlusive disease and sequential bypass is necessary in those patients with severe ischemia of the lower extremities.