主髂和股动脉闭塞症的手术治疗

目的　探讨主髂和股动脉闭塞症的最佳术式。方法　对 1 986年以来笔者经治的 4 1例 ( 45肢 )动脉硬化性闭塞症进行回顾分析。其中采用主—股旁路术 5例 ,髂—股旁路术 3例 ,股—动脉旁路术 6例 ,解剖外股—股或髂—股转流术 1 6例 ,腋—股动脉转流术 5例 (其中腋—双股转流术 1例 )、腹主—股深旁路术 1例和血栓内膜切除术 5例。结果　术后血运改善效果良好 ,且 Doppler和 A/B指数有不同程度改善者 38例 ( 92 .7% )。截肢 3例( 7.3% ) ,其中死亡 1例 ( 2 .4 % )。随访 33例 ( 80 .5 % ) ,5年通畅率为 70 .7%。结论　各种类型的旁路术疗效优于取栓或病变切除后旁路术 ,是治疗主髂和股动脉闭塞症的最佳术式。

Operative Treatment of Aorta iliac and Femoral-popliteal Arteriosclerotic Occlusion

Objective To approach the best operative mode for aorta iliac and femoral popliteal arteriosclerotic occlusion(ASO). Methods A retrospective analysis was made for forty one patients with ASO(45 limbs) undergone operations since 1986, including arota femoral artery bypass grafting for 5 cases, iliac femoral for 3, femoral popliteal for 6, extra anatomic shunt, such as femoral femoral for 16, axillary femoral for 5(axillary double femoral for 1) abdominal aortafernoral deep artery and embolectomy removal of intima plaque for 5. Results Post operative blood supply was satisfactorily improved in 38 cases (92.7 percent), amputation in 3 cases and one of them died (2.4 percent). By following up for 33 cases the five year unobstructive rate was 70.7 percent. Conclusion Curative effect of various type of bypass is superior to embolectomy or shunt after removal of pathological changes. It is the best way to save the limbs of the patients with ASO.