旁路移植人工血管闭塞原因分析及再手术的术式选择

目的 分析旁路移植人工血管闭塞的原因，探讨再手术术式的选择。方法 回顾性分析自1993年1月至2002年5月治疗的旁路移植人工血管闭塞患者47例。均给予再手术治疗，其中单纯人工血管切开取栓9例；人工血管取栓 吻合口成形16例；人工血管或自体大隐静脉再移植22例。结果 单纯人工血管切开取栓术及人工血管取栓 吻合口成形术的2年再闭塞率分别为67％、56％，明显高于人工血管或自体大隐静脉再移植手术术式的9％。结论 人工血管或自体大隐静脉再移植手术的效果明显优于单纯人工血管切开取栓术及人工血管取栓 吻合口成形术。

Prosthetic graft occlusion and options of reoperative modality

ObjectivesTo analyse the causes of occlusion of prosthetic grafts and to explore the appropriate modality of reoperation.MethodThe clinical data of 47 patients with occlusive prosthetic grafts were analyzed retrospectively. The procedure of treatment for patients with different causes of occlusive graft included thrombectomy alone in 9 cases, thrombectomy and anastomotic plasty in 16 cases, new bypass using prosthetic graft and saphenous autograft in 22 cases. ResultsThe reoccurrence of graft occlusion in patients undergoing thrombectomy alone or thrombectomy and anastomotic plasty was 67% and 56% respectively, which was siginificantly higher than that of 9% in patients treated by a new arterial bypass with prosthetic grafts and saphenous autografts. ConclusionsThe result of new bypass for occlusive prosthetic graft is superior to thrombectomy alone or thrombectomy and anatomotic plasty.