异体动脉移植临床应用的中远期随访

目的　对应用同种异体动脉移植修复肢体动脉缺损病例进行中远期随访 ,综合评价其临床应用价值。方法　对应用异体动脉移植修复肢体动脉缺损 3年以上的 2 2例患者进行随访 ,通过临床、多普勒仪、彩色超声波仪和远红外线仪的检查 ,了解移植血管的通畅情况及肢体血循环的变化。结果　较大肢体血管如股动脉、腋动脉和肱动脉的血管通畅率为 10 0 %。其中股→动脉 3例 ,腋→肱动脉 3例 ,移植血管的平均长度为 16cm。血管口径 <6mm的肢体血管如桡动脉 ,尺动脉的通畅率只有 5 6% ,其中40 %移植血管的闭塞发生在术后 1年内。结论　异体动脉移植对修复动脉口径 >6mm者疗效理想 ,对缺损动脉口径 <6mm的近期效果理想 ;但随术后时间的延长其通畅率下降 ,但对于肢体抢救及急诊修复中小动脉是有效的。

Intermediate and long term follow-up of clinical application of artery allografting

Objective To evaluate comprehensively the clinical value of artery allografting for repair of limb artery defect after intermediate and long follow-up studies. Methods Twenty-two cases who received the operation of artery allografting for repair of the limb artery defect more than three years ago were followed up. Clinical physical examination, Doppler and color ultrasonography, far infrared ray examination were done to detect the patency rate of the grafting artery and the circulation state of the injured limb. Results As to the major limb artery such as femoral artery, axilla artery and brachial artery, the patency rate was 100%. There were femoral to popliteal artery in 3 cases and axilla to brachial artery in 3 cases. The average length of grafting artery was 16 cm. As to those artery whose diameter less than 6 mm such as radial and ulnar artery, the patency rate was 56%, and 40% of the obstruction of grafting artery occurred within 1 year postoperatively. Conclusion Artery allografting can be used to repair the artery defect whose diameter was over 6 mm and the treatment outcome is satisfactory. When the artery is less than 6 mm, the short-term result is still good; but the patency rate declines with time after the operation. However, it is effective for limb salvage and emergent repair of artery of intermediate and small diameter.