锁骨下动脉盗血综合征25例报告

Subclavian steal syndrome:a report of 25 cases

我院１９８２～１９９２年共收治的２５例锁骨下动脉盗血综合征。主要病因是动脉硬化（１４例，占５６％）及大动脉炎（９例，占３６％），半数以上患者有长期吸烟史。主要临床表现为患肢脉弱或无脉（８８％），双上肢血压差别明显（９６％），脑缺血症状与手部运动关系密切等。本组手术治疗及扩张２０例，其中锁骨下动脉与颈总动脉架桥１５例，腋－腋动脉架桥２例，经胸升主动脉与颈总动脉架桥２例，经皮经腔血管成形术１例。术后上肢症状明显改善１５例（７５％），神经症状明显改善１０例（５０％）。随访２～１００个月，有效率达８５％。文内就病因、诊断、偷流对脑血流的影响以及手术适应证和各类手术方式的优缺点进行了比较。

AbstractFrom 1982 to 1992,25 patients with subclaviansteal syndrome(SSS)were admitted wilh 20 undergo-ing surgery.Etiology included atherosclerosis 56%(14/25),Takavasu’disease 36%(9/25) ,14 of themwere smokers.Stenosis or occlusion of the left subcla-vian artery were found in 14 the right in 7,and bilat-eral in 4.14 cases had vertigo symptoms,24 cases hadclaudication of the arm,9 of them complained transientischemic attack(TIA).Carotid to subclavian bypass were performed for15 cases,Two patients underwent axilloaxillary bypasswith evidence of both clinical and laboratory improve-ment. Aorta-Carotid graft bypass was done in 2 caseswith good resuIt in one. PTA was done for a girl withinnominate severe stenosis but symptom recurred threemonths later. Symptoms of the upper extremity is-chemia were relieved in 75%of the patients, and of thecerebrovascular ischemia in 50%。Our conclusion is that surgicaI therapy remainsthe treatment of choice in symptomatic patients.