主髂动脉闭塞手术方式的选择

Management of arterial occlusive diseases of abdominal aorta and iliac artery

目的 :探讨腹主动脉下段及髂动脉闭塞手术方式的选择。方法 :对我院 1996年 3月至 2 0 0 2年 1月 4 8例主髂动脉闭塞病例进行回顾性总结。结果 :行主 髂 (股 )动脉人工血管转流术 15例 ,髂 股动脉人工血管转流术 10例。髂动脉内膜剥脱术 1例 ,股 -股动脉人工血管转流术 10例 ,腋 -股动脉人工血管转流术 12例。均得到随访。总有效率 95 8% ,围手术期死亡率 4 17%。人工血管通畅率81 2 %。结论 :解剖途径人工血管转流术是治疗本病的首选方法 ,以获得较高的通畅率。对于高龄、体弱者 ,特别是全身一般情况差 ,合并高血压、糖尿病、冠心病、肺气肿等慢性病的患者 ,应采用解剖外途径人工血管转流术 。

Objective:To discuss the proper procedure treatment of infrarenal aortic and iliac arterial occlusion. Method:We reviewed 48 patients with infrarenal aortic and iliac arterial occlusion. They were admitted in our hospital from March 1996 to January 2001. All patients were treated by surgery including aorta\|iliac or aorta\|femoral bypass in 15 cases, iliac\|femoral bypass in10 cases, thromboendarterectomy of iliac artery in 1 case, femoro\|femoral bypass in 10 cases ,axillo\|femoral artery bypass in 12 cases.Result:All patients were followed up. The total efficient rate and perioperative mortality were 95 8%and 4 17%. The patency rate of grafts is 81 2%. Conclusion:Anatomical bypass is the best choice with a high patency rate. The extra-anatomic route can reduce the mortality rate to the senile patients,especially for those with bad general condition or those combined with some chronic disease,such as hypertension, diabetes, coronary heart disease, emphysema etc. [