老年人重症肢体缺血的治疗经验总结

Overview of the Treatment for Critical Limb Ischemia in the Aged

目的探讨不同治疗方法对老年人重症肢体缺血（CLI）的疗效。方法回顾性分析2003年1月至2006年12月采用不同方法治疗的141例65岁以上病人CLI的临床资料。结果113例得到随访，平均62个月，动脉旁路术75例，其1、3、5年通畅率及保肢率分别为67％、51％、49％及84.1％、76.1％、73.8％；介入治疗15例，其1、3、5年通畅率及保肢率分别是73．5％、60％、53.3％及866％，73.3％、66.7％；联合治疗7例，其1、3、5年分别有5、4、4例保持通畅；自体骨髓干细胞移植有效率81．3％（13／16）。结论老年人周围动脉病变复杂，合并症多，针对老年人CLI的临床特征综合制定治疗方案是理想选择。

Objective：To explore the efficacy of different treatment for Critical Limb Ischemia（CLI） in the aged. Methods： The data of 141 cases aged ≥ 65ys,underwent different therapeutics from January 2003 to december 2006, were retrospectively reviewed. Results： 113 cases were followed up,averaged 62 months. Patency rate and limb salvage rate of bypass were 67%. 51%. 49% and 84.1%,76.1%,73.8% at 1-, 3- and five-year respectively;Patency rate and limb salvage rate of intervention were 73.3%, 60%, 53.3% and 86.6%, 73.3%, 66.7% at 1-, 3- and five-year respectively; Therapeutic alliance of 7 cases have 5 cases at one year, 4 cases at three years and five years keeping patent respectively. Effective power of autologous bone marrow stem ceils transplantation is 81.3%.Conclusion： The aged have more complications and complex peripheral arterial disease. Comprehensive Therapeutics should be made according to different clinical characters of the aged with CLI.