周围动脉闭塞性疾病的旁路手术治疗

Bypass to treat atherosclerotic oblieration in limbs

目的 :探讨周围动脉闭塞性疾病的动脉旁路手术治疗方法。方法 :6 5例周围动脉闭塞性疾病 ,采用彩色多普勒及动脉造影检查确定病变范围。 5 2例术前应用超声多普勒血流仪行节段动脉压测定和计算踝 /肱指数。根据动脉狭窄或闭塞病变范围 ,实施动脉旁路重建。术中自体大隐静脉移植 38例 ,人工血管移植 2 7例。结果 :48例患者随访 6～ 36个月 ,经彩色多普勒及动脉造影检查 ,通畅率为 83 5 % ,踝 /肱指数由术前平均 0 41达到 0 88。结论 :动脉旁路术是治疗动脉闭塞性疾病的有效的手术方法 ,动脉流入、流出道的畅通 ,是手术成功的关键。多节段性动脉闭塞病变 ,可设计多平面分段旁路转流术或通过动脉内膜剥脱扩大流出道口径 。

Objective:The purpose of this study was to evaluate the theraputic experience of bypass openration to treat 65 cases of atherosclerotic oblieration in limbs Methods: Ages of the patients were 25～76 years, the average ages 53 years The course of disease two month to four years The color doppler ultasound angiograph and intra arterial angiography can showed the region of the artery lesion and degree on preoperative examination There were 52 cases by segmental arterial pressure determination and count ankle/brachial index(A/BI) be examine The average A/BI was 0 41(0 23～0 52) According to the arteriostenosis and obstruction scope, all cases underwent bypass operation 38 cases oneself great saphenous vein and 27 cases blood vessel prosthesis were grafted Results: Six to thirty six month after operation, 48 cases patients perform the color doppler ultasound angiograph and angiography examination, the arterial reconstructive patency rate was 83 5%, the average A/BI was 0 88 (0 7～0 98) Conclusions: Itis safe and effectiveto perform bypass operationfor atherosclerotic oblierationin limbs The key of successful operatione lies in that the condition of the inflow and outflow of the arterial reconstruction are patent