血管搭桥胫后静脉动脉化治疗下肢严重缺血症

ARTERIALIZATION OF THE POSTERIOR TIBIAL VEIN WITH A VASCULAR BRIDGE IN TREATING SEVERLY ISCHEMIC LOWER LIMBS

目的：解决静脉动脉化存在的静脉回流障碍、窃血等问题。方法：设计了应用Ｇｏｒｅ－Ｔｅｘ血管搭桥，仅使一条胫后静脉一期动脉化的术式。临床为５例６侧下肢严重缺血的患者实施手术。结果：术后下肢缺血性疼痛消失，无肿胀，１４～８０天创面愈合；动脉造影和多普勒超声探测证实患足血供良好。结论：本术式可以保证其它静脉回流的完整性、窃血也少。应用Ｇｏｒｅ—Ｔｅｘ血管搭桥的长度与粗细不受自身浅静脉条件和动脉闭塞程度的限制。该术式安全、简便、副损伤小、疗效确切。

Objective:To resolve the problems of disturbances of reflux and steal blood phe-nomenon in lower limbs. Metbods:6 limbs of 5 patients suffering from severe ischemia of legs were treated with Gore-Tex vascular to bridge femoral or popliteal arteria between vein of posterior tibi-a. Results:The blood supply of the legs recovered immediately after operation. The pain and swelling disappeared.The ulcer of legs was healed slowly.Conclusions:Using Gore-Tex vascular to bridge femoral or popliteal arteries between the vein of posterior tibia can resolve the problems of reflux and steal blood phenomenon in lower limbs. The operation is safe,simple and effective.