动脉硬化闭塞症下肢缺血48例外科诊治分析

目的 探讨下肢动脉硬化闭塞症的诊治经验。方法 对48例下肢动脉硬化闭塞症患者进行治疗，其中药物保守治疗3例，解剖外血管重建4例，腔内治疗或合并开放性血管重建6例，单纯开放性手术35例。结果 除2例患者术后住院期间死亡外，其余患者症状得到明显改善，提高了生存质量。平均随访时间2．8年（3月～5年）。随访期间移植血管通畅率为73％。结论 患者的全身状况、血管病变的范围和程度是外科治疗下肢动脉硬化闭塞症的主要依据。血管重建术仍然是治疗下肢动脉硬化闭塞症的较好方法。

Arteriosclerosis Obliterans in the Lower Extremities in Forty-eight Cases

Objective To review our experience of surgical treatments of arteriosclerosis obliterans in the lower extremities.Methods Forty eight patients with arteriosclerosis obliterans in the lower extremities of which 3 were treated with drug,45 were performed surgical operations.Of 45 patients,extra-anatomic bypass were performed in 4 patients,endovascular treatment combined open vascular operations in 6 patients and pure vascular operations was conducted in 35 patients.Results Two patients died after operation in the hospital.The symptoms of critical ischemia in the extremities were ameliorated in the other patients after operation.Mean period of fllow-up was 2.8 years(ranging 3 months to 5 years).The primary patency rates was 73% during the period of fllow-up.Conclusion The proper selection of surgical treatments for arteriosclerosis obliterans relies on the severity of the vascular disease.It is an effective therapy to perform arterial reconstruction for the lower extremity arterial occlusion.