下肢动脉硬化闭塞症自体大隐静脉转流术后移植血管闭塞相关因素分析

Analysis of risk factors of vein-graft occlusion after autologous great saphenous vein bypass surgery in patients with atherosclerosis obliterans

目的:探讨下肢动脉硬化闭塞症(ASO)自体大隐静脉转流术后移植血管闭塞的相关因素。方法:收集2014年1月-2017年4月于山东省立医院、菏泽市中医医院、济南市中医医院确诊为ASO且行自体大隐静脉旁路转流术的112例患者的临床资料,根据移植血管是否发生闭塞分为未闭塞组(A组)与闭塞组(B组),比较两组患者年龄、性别、体质量指数、手术方式、移植血管长度、移植血管直径、术前及术后踝肱压力指数等指标的差异。结果:闭塞组患者39例,未闭塞组患者73例。两组手术时长、术前ABI及术后即刻ABI比较差异均无统计学意义(P>0.05)。Logistic回归分析显示,手术方式、移植血管长度和移植血管直径是自体大隐静脉转流术后移植血管闭塞的危险因素。结论:下肢动脉转流手术方式、移植血管长度和移植血管直径是影响移植血管闭塞的危险因素,术前流出道的评估和术式的选择有利于维持移植血管的通畅性。

Objective:To investigate the related factors of vein-graft occlusion after autologous great saphenous vein bypass in patients with arteriosclerosis obliterans of lower extremity.Methods:From January 2014 to April 2017,the information of 112 patients with ASO diagnosed in Shandong Provincial Hospital of traditional Chinese Medicine,Heze Hospital of Traditional Chinese Medicine and Jinan Municipal Hospital of Traditional Chinese Medicine were collected.According to whether the vein-graft was occlusion,patients were divided into the unocclusive group(group A)and the occlusive group(group B),The factors such as age,sex,body mass index,surgical mode,length of vein-graft,diameter of vein-graft,ankle and brachial pressure index before and after operation were compared and analyzed.Results:The occlusion occurred in 39 patients.According to the statistical analysis,the operation method,the length of the vein-graft and the diameter of the vein-graft were the risk factors of vein-graft occlusion after autologous great saphenous vein bypass.Conclusion:The operation method of bypass surgery,the length and diameter of vein-graft are the risk factors of vein-graft occlusion.The evaluation of outflow vessel before operation and the choice of operation method are beneficial to maintain the patency of vein-graft.