急性下肢缺血的杂交手术治疗

Hybrid Surgery in Treatment of Patients with Acute Lower Limb Ischemia

目的本研究的目的为评估杂交手术在急性下肢缺血治疗中的作用。方法回顾性分析2006年1月—2011年12月我科对31例急性下肢缺血患者(35条肢体)行急诊杂交手术的临床资料,平均随访12个月,对患者的通畅率、保肢率及生存率进行分析。结果 31例患者FontaineⅡa级9例,Ⅱb级22例,即时手术成功率为100%,ABI由术前的0.24±0.11上升到术后的0.72±0.15(P<0.05),围手术期并发症发生率和病死率分别为16.1%、0,12个月通畅率、保肢率及生存率分别是93.3%、96.7%和96.8%。结论对于多平面病变的急性下肢缺血,杂交手术是一种安全有效的治疗方法。

Objective To investigate the clinical effect of hybrid surgery in treatment of patients with acute lower limb ischemia （ALLI）. Methods Clinical data of 31 ALLI patients （35 limbs） undergoing emergent hybrid surgery during January 2006 and December 2011 was retrospectively analyzed. The average follow-up time was 12 months, and the patency, limb salvage and survival rates were also analyzed. Results Among the 31 patients, 9 patients were Fontaine Ⅱ grade A, and 22 patients were Fontaine Ⅱ grade B. The successful rate of immediate surgery was 100% , and the average ankle/brachial index （ABI） value was increased from preoperative 0.24 ± 0.11 to postoperative 0.72 ±0.15 （P 〈0. 05）, and perioperative morbidity and mortality rates of complications were 16.1% and 0 respectively, and the patency, limb salvage and survival rates of 12 months were 93.3%, 96.7% and 96.8% respectively. Conclusion The hybrid surgery is a safe and effective treatment method for ALLI patients with multilevel lesions.