远端动脉旁路术治疗重症下肢缺血

Distal arterial bypass for treatment of critical lower limb ischemia

[目的]探讨远端动脉旁路术在治疗重症下肢缺血中的作用。[方法]回顾性分析了2003年1月～2007年3月应用远端动脉旁路术治疗的36例重症下肢缺血病人。[结果]36例中33例（91．7％）术后患肢静息痛消失，皮肤温度、颜色明显改善，踝肱指数均值由术前0．12±0．15升为术后0．87±0．21，两者之间差异有统计学意义（P〈0．001）。术后随访31例，随访时间1～3年（平均2年），术后1、2、3年移植血管的一期累计通畅率分别为85％、72％、70％，二期累计通畅率分别为87％、73％、72％。[结论]远端动脉旁路术是治疗重症下肢缺血，挽救患者肢体的有效方法之一。

[Objective] To assess the clinical effects of distal arterial bypass for the treatment of critical lower limb ischemia.[Methods] We retrospectively analyzed 36 patients with critical lower limb ischemia, for which distal arterial bypass was performed from January, 2003 to March, 2007. [Results] In 33 cases （91.7%） symptoms were relieved, with resting pain disappeared and skin temperature improved. Ankle brachial index （ABI） increased significantly from 0.12 ± 0.15 to 0.87±0.21 perioperatively （P 〈 0.001）. Postoperatively, 31 cases were followed up for 1 year to 3 years. The primary graft patency rates in this series were 85% , 72% and 70% in 1 year, 2 years and 3 years, respectively. The secondary graft patency rates were 87% , 73% and 72% in 1 year, 2 years and 3 years, respectively. [Conclusion] The distal arterial bypass is one of the effective methods for the treatment of critical lower extremity ischemia and the salvage of the limbs.