血管旁路与动静脉转流治疗下肢动脉硬化闭塞症的疗效比较

Curative comparison of blood vessel bypass and arteriovenous reversal in the treatment of aterosclerotic obturation at lower extremities

目的评价血管旁路及动静脉转流术在治疗下肢动脉硬化闭塞症中的疗效。方法1998-01～2004-01对该病患者109例119条下肢．采用2种术式：①血管旁路：在股一胭动脉、腘-胫腓干动脉之间建立血管旁路；②动静脉转流：在股浅动脉-股浅静脉、腘动脉-胫腓干静脉之间建立动静脉转流,进行治疗观察。结果119条下肢随访4个月至5年,平均3年左右。血管旁路组79条下肢疗效满意或病情改善,1条截肢。动静脉转流组39条下肢疗效满意或病情改善,无截肢。结论血管旁路及动静脉转流在救治下肢动脉硬化闭塞症方面各有其优缺点,故应严格选择病例,掌握手术技巧,增加患肢救治率。

Objective The evaluate the therapeutic effects of blood vessel bypass and arteriovenous reversal in the treatment of artero-sclerotic obturation at lower extremitles.Methods From January 1998 to January 2005, 109 patients（119 legs） were subjected to two kinds of procedures：（1）blood vessel bypass： femoral to popliteal arteria, and popliteal to tibioperoneal arteria;（2）arteriovenous reversal： superficial femoral artery to superficial femoral veins, and popliteal arteria to tibioperoneal veins.Results For the patients the followed - up of four months to five years,averaged 3 years,were taken. The 80 legs of blood vessel bypasses showed satisfactory results or improvement, except one case received amputation.The 39 legs of arteriovenous reversal showed satisfactory results without amputation.Conclusion There are different characteristic of the blood vessel bypass and arteriovenous reversal for curing legs.It should be strictly selecting cases, mastering the technique of operation,so as to increase the surviving rate of leg.