分期动静脉转流治疗肢体动脉闭塞症176例

目的探讨分期动静脉转流术治疗血栓闭塞性脉管炎(TAO)和动脉硬化闭塞症的远期效果。方法回顾性分析176例分期动静脉转流术的临床资料。结果147例获随访,随访率83 5%,中位随访时间9 8年。6例上肢和84例下肢低位深组转流患者中, 86例(95 5% )术后1周疼痛消失,肢体保留率100%。57例下肢高位深组转流者中, 43例(75 4% )疼痛术后2 ~3周消失,术后5例截肢,截肢率8 8% (5 /57),肢体保留率91 2%。结论分期动静脉转流治疗TAO和广泛性动脉硬化闭塞症临床效果满意,但应严格掌握手术适应证。

Clinical analysis of staged arteriovenous shunts for the treatment of arterial occlusive disease of the limbs

Objective To evaluate the result of staged arteriovenous shunts for the treatment of thromboangiitis obliterans(TAO) and arterial sclerosis obstruction (ASO). MethodsData of 176 cases undergoing this procedure were retrospectively reviewed. ResultsIn this group, 147 cases (83 5%) were followed up with a median of 9 8 years. Pain and/or claudication disappeared in 86 out of 90 cases (95 5%) treated by low positioned shunt one week postoperatively, with a limb salvage rate of 100%. Among 57 cases treated by high positioned shunts of the lower limbs, pain and claudication disappeared in 43 cases (75 4%) 2~3 weeks postoperatively. Postoperative amputation has to be performed in 5 cases with a limb salvation rate of 91%. ConclusionsThe clinical result of this staged arteriovenous shunts is satisfactory for the treatment of thromboangiitis obliterans(TAO) and arterial sclerosis obstruction (ASO).