先天性肢体动静脉瘘手术治疗体会

Surgical treatment of congenital arterio-venous fistula in the extremities:report of 45 cases

目的总结先天性肢体动静脉瘘45例手术治疗体会。方法采用瘘管结扎和病变切除,瘘管结扎、病变切除和血流重建,分期分段瘘管结扎3种手术方法处理先天性肢体动静脉瘘。其中上肢13例,下肢32例。结果除4例失访外,其余41例平均随访5.7年。疗效良好者17例(41.5%);好转16例(39%)。总有效率达80.5%。结论选择性动脉造影是诊断和治疗先天性动静脉瘘的重要依据,瘘管结扎和病变切除是手术成功的关键。

Objective To appraise the surgical treatment of congenital arterio-venous fistula(CAVF).Method 45 patients with CAVF in the extremities were treated surgically with ligation of the arterio-venous fistulas,excision of the arterio-venous malformation and reconstruction of the circulation by autologous vein graft.Result The re- suits were excellent in seventeen and good in sixteen patients.The total effective rate was 80.5% with a mean follow up period of 5.7 years.Conclusion Angiography is crucial for the diagnosis.Surgical excision and liga- ture of fistula remains a effective method.