青少年腘动脉陷迫综合征诊治分析(附17例报告)

Diagnose and treatment for popliteal artery entrapment syndrome in young people:A repont of 17 cases

目的总结青少年腘动脉陷迫综合征(popliteal artery entrapment syndrome,PAES)的影像学诊断与手术治疗经验。方法 2003年7月至2012年2月,山东大学附属省立医院对17例(18条下肢)青少年PAES病人术前施行了多普勒超声、CT血管成像(CTA)或MR检查,并对17条患肢施行了相应的手术治疗,监测手术前后患肢踝肱指数(ankle brachial index,ABI)变化。结果 13条患肢施行了腘动脉周围异常组织松解术,其中5条因动脉闭塞同时施行了大隐静脉旁路移植术,4条患肢因动脉内膜增厚实行腘动脉内膜切除+动脉成形术;4条肢体行自体大隐静脉移植术。16例病人随访6个月至6年,平均(30.88±19.88)个月,所有手术肢体间歇性跛行症状治愈,踝肱指数由术前的(0.47±0.09)上升至术后的(0.96±0.07),较术前显著提高(P<0.01)。1例病人因肺动脉栓塞术后1 d死亡。结论 PAES是青少年下肢动脉缺血的一个重要病因。影像学诊断是确诊该病的重要手段,早期积极外科干预预后较好。

Diagnose and treatment for popliteal artery entrapment syndrome in young people：A repont of 17 cases ZHANG Jing-yong, WANG Mao-hua,JIN Xing,et al. Department of Vascular Surgery,Provincial Hospital Affiliated to Shandong University,Jinan 250021,China Corresponding author：JIN Xing,E-mail：zhangjingyongys@163.com Abstract Objective To summarize experience of imaging diagnosis and surgical treatment in popliteal artery entrapment syndrome （PAES） in young people. Methods From July 2003 to February 2012,17 patients （18 lower extremities） with PAES were performed doppler ultrasonography,CTA and MR before surgery and then performed surgery in Provincial Hospital Affiliated to Shandong University. Ankle brachial indexes （ABI） of all patients were contrasted before and after operation. Tenolysis of malformed muscle round of popliteal artery was performed in 13 lower extremities,in addition,bypass in 5 lower extremities with artery occlusion,endarterectomy and artery autoplasty in 4 lower extremities with artery stenosis and simple femoral-popleteal bypass with great saphenous veins in 4 lower extremities. Results The average time of follow up was（30.88±19.88）months （6 months—6 years）. Symptom of intermittent claudication was disappeared in all patients. ABI ascended from（0.47±0.09）before operation to（0.96±0.07） after operation with significant difference （P〈0.01）. One patient died of pulmonary embolism 1 day after surgery. Conclusion PAES is an important cause of arterial ischemia of the lower extremity. Imaging diagnosis is very important. It will have a favourable prognosis with active surgery in early time.