血管旁路移植术治疗下肢动脉硬化闭塞症

目的评价血管旁路移植术治疗下肢动脉硬化闭塞症的效果。方法对20例(23条下肢)下肢动脉硬化闭塞症患者进行了不同方式的血管旁路移植术。同时,术中行下肢动脉造影12条,实时评价吻合口及流出道情况。结果术后22条下肢疼痛消失,肢体溃疡愈合,1例疼痛减轻。21条下肢动脉移植物通畅。术中造影发现2例流出道较术前改善不明显而进一步修正手术方案,2条胫前、胫后动脉近端闭塞而行序贯旁路手术。结论对于膝关节以上动脉闭塞采用人造血管旁路移植术有较好的效果。术中动脉造影对于实时评价吻合口及流出道情况有较好的临床应用价值。

Bypass grafting in the treatment of atheriosclerotic occlusion of lower extremities

Objective To evaluate the effect of bypass grafting in the treatment of atheriosclerotic occlusion of lower extremities.Method Twenty patients(23 lower extremities) underwent different style bypass grafting.Intraoperative angiography was performed in 12 extremities.Results Pain was released in 22 lower extremities and eased in 1.Ulcers in lower extremities healed.Grafts in 21 extremities were patent.By intraoperative angiography,run-off was found improved and operative strategy was further revised in 2 extremities and occlusion in proximal part of anterior and posterior tibial arteries was confirmed and sequencial bypass was performed in 2.Conclusion Better effect can be obtained by artificial grafting in the treatment of above-knee arterial occlusion.Intraoperative angiography has better value of clinical application for real-time assessing of anastomosis and run-off.