股-股动脉人工血管转流术治疗高危主髂动脉闭塞症的临床研究

Femorofemoral bypass in the treatment of high-risk patients with aortoiliac artery occlusive disease

目的:探讨股-股动脉人工血管转流术治疗高危单侧主髂动脉闭塞症。方法:回顾性分析2004年7月～2006年10月应用股-股动脉人工血管转流术治疗高危重症单侧主髂动脉闭塞症9例。术前均有静息痛。踝肱指数为0.25±0.15。结果:9例均行股-股动脉耻骨上人工血管转流术,一期行患侧股-腘动脉转流术2例,腘动脉切开取栓术4例,股总动脉和股深动脉开口内膜剥脱术5例,均获得成功,无重要脏器并发症和手术死亡。术后1周踝肱指数为0.67±0.15,与术前相比有显著提高(P<0.05)。平均随访12个月(4～30个月),1例术后17个月出现静息痛,2例残余有轻度间歇性跛行。结论:股-股动脉人工血管转流术在治疗高危重症单侧主髂动脉闭塞症中有着重要的临床价值。

Objective： To study femorofemoral bypass in the treatment of high-risk patients with unilateral aortoiliac artery occlusive disease. Methods： Retrospective clinical study was used to analyze 9 high-risk patients suffering from unilateral aortoiliac artery occlusion from July 2004 to October 2006. Femorofemoral bypass was performed on these 9 patients （8 men and 1 woman, 72.1 years on average）. There was severe rest pain in all of the patients before operation. Preoperative ankle-brachial index（ABI） was 0.25±0.15. Results： Nine femorofemoral bypass were performed with simultaneous 2 femoropopliteal bypass and 4 popliteal artery embolectomy and 5 endarterectomy of common femoral artery and profound femoral artery. Surgical procedures were technically successful in all patients. There was no post operative morbidity or mortality. Postoperative ABI（one week later） was 0.67±0.15 （P〈0.05）. The mean following-up period was 12 months （4 to 30 months）. One patient had rest pain at 17 months after the operation, and two patients had moderate claudication. Conclusion： Femorofemoral bypass is a safe surgical alternative to treat the high-risk patients with unilateral aortoiliac arterv occlusive disease.