腋-股动脉旁路移植救治慢性重症下肢缺血

Axillofemoral bypass for the treatment of chronic severe lower limb ischemia

目的探讨腋 股动脉转流救治慢性重症下肢缺血的疗效。方法回顾性分析 1995年 1月至 2 0 0 2年 11月的 6 3例主髂动脉闭塞患者行腋 单股和腋 双股动脉人工血管旁路移植的临床资料。结果 4 4例出院时静息痛消失 ,19例患者间歇跛行消失 ,平均踝 肱比从术前的 0 18(0～0 4 9)提高到 0 6 8(0 2 9～ 1 0 4 )。本组肢体救治率 87 4 % ,截肢率 7 9%。 3例死亡 ,手术死亡率是4 7%。 1、3、5年通畅率分别为 93 2 %、79 8%、6 4 1%。结论因主髂动脉闭塞导致慢性重症下肢缺血的高危患者 ,通过腋 股动脉人工血管旁路移植可有效的挽救肢体和生命。

ObjectiveTo evaluate axillofemoral bypass(AxFB) for the treatment of chronic severe lower limb ischemia. Method Consecutive AxFB performed in Anzhen Hospital from January 1995 to November 2002 was retrospectively analysed, with 31 patients of aortoiliac occlusive disease undergoing axillobifemoral bypass (AxBFB) and 32 axillounifemoral bypass(AxUFB) respectively. Result On discharge, rest pain disappeared in 44 cases and intermittent claudication in 19 cases, with average ankle/brachial index changing from preoperative 0.18(0～0.49) to postoperative 0.68(0.29～1.04). Rate of limbs salvage was 87.4%, amputation rate was 7.9%. Three cases died with a perioperative mortality of 4.8%. The patency rate of 1,3,5 years were 93.2%,79.8% and 64.1%, respectively. Conclusion AxFB for aortoiliac occlusive disease is considered to be acceptable procedure in high-risk patients with poor femoral run-off and chronic critical lower limb ischemia.