多发性大动脉炎的外科治疗

Surgical treatment of takayasu arteritis

目的 研究多发性大动脉炎的手术治疗问题。方法 分析近年我们收治的23例本病患者,其中头臂型10例,胸腹主动脉型5例,肾动脉型2例,混合型6例。结果 手术19例,术后死亡2例,1例因高灌注性脑水肿,1例为重度循环功能紊乱,术后生存率为89.5％。结论 手术通过重建动脉循环,明显改善了血流动力学及缺血组织血供,有效提高了大动脉炎患者生命质量。

Objective To study the experience in the treatment of takayasu ar-teritis. Methods 23 cases of takayasu arteritis were analysed retrospectively from October 1996 to may 1999. Of them,4 cases were male and 19 female. The ages ranged between 16 and 49 years (mean age, 32. 4 years). Ten of them were aortic arch type, 5 thoracoabdominal arterial type, 2 renal arterial type and 6 extensive type. Results Vascular reconstruction were performed on 19 cases. Among them, carotid reconstruction was done in 9 cases, subclavian reconstruction in 1, thoracoabdominal aortic bypass in 5, renal arterial reconstruction in 4. There was a mortality rate of 10. 5%. They died of brain edema and hemodynamic dysfunction respectively. Conclusion Surgical procedures reconstructed the path of the arterial circulation, significantly improved blood supply of ischemic tissues, and increased the life quality of the patients.