下肢动脉硬化闭塞症腓肠动脉的病理变化与侧支流出道构建

目的为下肢动脉粥样硬化闭塞症(arterial sclerosis obstruction,ASO)末期利用腓肠动脉构建流出道提供病理学及解剖学基础。方法在11例膝上截肢的新鲜离体标本上向动脉内灌注红色乳胶,解剖观察腘动脉及腓肠动脉的病理改变,提出构建腓肠动脉流出道的设想,并对收治的9例末期ASO患者进行下肢动脉造影,示股动脉、腘动脉及分支均不显影;B超示腘动脉基本闭塞。行腘动脉探查术,完成腓肠动脉成形及股腘动脉旁路转流术。结果解剖观察结果:①腘(胫)动脉管壁僵硬,动脉粥样斑块填满管腔。②腓肠动脉开口处分3种病变形态:开放型、膜式狭窄闭塞型及柱状闭塞型。③临床上对腓肠动脉开口处成形,建立腓肠动脉流出道,再行股腘动脉旁路转流术。结果显示术后临床症状消失,皮温逐渐回升,下肢溃疡两月内逐渐愈合。B超显示腓肠动脉代偿性扩张。结论通过解剖及临床研究结果显示,腓肠动脉流出道的构建是解决末期ASO患者的有效途径之一。

Pathological changes of sural arteries in ASO and the construction of collateral outflow tract

Objective To provide pathologic and anatomic basis for constructing outflow tract adopting sural arteries at the end stage of arterial sclerosis obstruction(ASO).Methods The red emulsion was infused into the arteries of 11 fresh upper leg specimens getting from knee amputation,after that,the pathologic changes of sural and popliteal arteries were dissected and analyzed.As well,the construction of collateral outflow tract was proposed.For 9 patients of ASO,lower extremity arteriography was undertaken,which p...