胫骨迁移血管再生治疗血栓闭塞性脉管炎35例分析

Vessel regeneration by tibial bone immigration on the thromboangiitis obliterans:an analysis of 35 cases

目的 评价胫骨迁移血管再生治疗血栓闭塞性脉管炎的手术成功率和长期有效率。 方法 对2000年11月至2006年11月黑龙江省医院周围血管病科胫骨迁移血管再生治疗血栓闭塞性脉管炎的资料进行分析。35例血栓闭塞性脉管炎病人进行动脉造影，选择股浅动脉下段闭塞或腘动脉闭塞股深动脉流出道良好的病人行手术治疗。分离病人的胫骨并每天缓慢迁移分离的胫骨，通过刺激胫骨骨髓再生新鲜小动脉和毛细血管网改善缺血区供血。 结果 35例中32例获得满意疗效，随访时间2~6年。临床缺血症状彻底改善。3例术后3个月后仍有严重下肢缺血行下肢截肢术。总有效率91%。 结论 胫骨迁移血管再生手术可以有效治疗血栓闭塞性脉管炎，手术方法简单，安全有效，且治疗费用低，值得临床推广。

Objective To evaluate the clinical efficiency of vessel regeneration by tibial bone immigration on the thromboangiitis obliterans. Methods The clinical data of patients with thromboangiitis oblitera.ns performed the treatment of vessel regeneration by tibial bone immigration from November 2000 to November 2006 at the Hospital of Heilongjiang Province were analyzed. After the arteriography, 35 patients with the good outflow in the deep femoral artery, who had the occlusion in the popliteal artery or in the inferior segment of the femoral artery, received the operation of vessel regeneration by moving the tibial bone. To stimulate the regeneration of new vessels and the capillary in the ischemic lower limbs, the slow immigration of the separated segment of the tibial bone was performed everyday. Results Thirty-two of 35 patients showed satisfactory curative effects in 2-6 years after operations. Three patients were performed the lower extremity amputation because of severe ischemia occurred in 3 months after operations. The total effective rate was 91%. Conclusion Vessel regeneration by tibial bone immigration is effective to the thromboangiitis obliterans. The method is worthy of popularization because of its simple procedure, reliable safety and low spends.