下肢动脉旁路移植术后人工血管闭塞的再手术治疗

Trea^rnent of reoperation on blood vessel prosthesis occlusion after arterial bypass graft in lower limbs

目的总结下肢动脉旁路移植术后人工血管闭塞的再手术治疗经验。方法回顾性分析21例下肢动脉旁路移植术后人工血管闭塞患者再手术的治疗效果。结果21例患者术后均获随访，随访时间6～36（12士3）个月。肢体存活率71．4％（15／21），截肢率28．6％（6／21），9例最后通过股深动脉供血的患者肢体全部存活。结论下肢动脉旁路移植术后人工血管闭塞的主要原因是内膜增生或流人道及流出道的狭窄闭塞，再手术前应仔细分析闭塞原因以选择合适的手术方式。股深动脉重建对于人工血管闭塞的再手术治疗非常重要。

Objective To review reoperation on blood vessel prosthesis occlusion after arterial bypass graft in lower limbs. Method The treatment effect of 21 patients with reoperation on blood vessel prothesis occlusion after arterial bypass graft in lower limbs was analyzed retrospectively. Results All the cases were followed up 6-36 （ 12 ±3 ） months. The limb salvage rate was 71.4% （ 15/21 ）, the amputation rate was 28.6% （6/21）. All 9 limbs that underwent revascularization from deep femoral artery reserved. Conclusions Endomembrane hyperplasy, occlusion of the inflow and outflow tracts are the major reasons for the occlusion of blood vessel prosthesis after arterial bypass graft in lower limbs. Appropriate procedures should be based on careful consideration of the occlusion reasons. Profundaplasty is an effective therapy for those who are treated by reoperation on blood vessel prosthesis occlusion in lower hmbs.