复杂股腘动脉硬化闭塞症的杂交手术治疗

目的:评价杂交手术治疗复杂股腘动脉硬化闭塞症的疗效。方法:回顾性分析2013年3月—2015年6月行杂交手术治疗的56例复杂股腘动脉硬化闭塞症患者(65条患肢)的临床资料。用踝肱指数(ABI)、Rutherford分级、通畅率等指标对手术效果进行综合评价,采用Kaplan-Meier法分析术后患肢通畅率。结果:56例患者(65条患肢)手术均取得成功,无截肢或死亡病例,围手术期并发症发生率14.29%(8/56)。术后平均ABI较术前升高(0.76vs.0.28),平均间歇性跛行距离从术前168m提高至530m,差异均有统计学意义(P0.05);Rutherford分级不同程度提高。随访时间12~33个月,术后6个月及1、2年的一期通畅率分别为93.85%、81.54%、70.77%,二期通畅率分别为98.46%、95.38%、90.77%。结论:杂交手术治疗复杂股腘动脉硬化闭塞症安全有效。

Hybrid procedures for complex arteriosclerosis obliterans in femoropopliteal segment

Objective: To evaluate the clinical efficacy of hybrid procedures in treatment of complex arteriosclerosis obliterans in the femoropopliteal segment. Methods: The clinical data of 56 patients (65 limbs) with complex arteriosclerosis obliterans affecting the femoropopliteal segment undergoing hybrid operation from March 2013 to June 2015 were retrospectively analyzed. The treatment efficacy was evaluated by analyses of the ankle brachial index (ABI), Rutherford category and patency rate. Patency was analyzed by using Kaplan-Meier method. Results: The hybrid procedures were successfully performed in all the 56 patients (65 limbs), no amputation was needed and no death occurred and the incidence of perioperative complications was 14.29% (8/56). The postoperative average ABI was increased compared with preoperative value (0.76 vs. 0.28), and the distance of intermittent claudication was prolonged from 168 m before operation to 530 m after operation, and both differences had statistical significance (both P<0.05); the Rutherford grades were improved in different degrees. The patients were followed up for 12 to 33 months, and the 0.5-, 1- and 2-year primary patency rate was 93.85%, 81.54% and 70.77%, and secondary patency rate was 98.46%, 95.38% and 90.77%, respectively. Conclusion: Hybrid procedures are safe and effective in treatment of complex arteriosclerosis obliterans in the femoropopliteal segment.