老年人腹主动脉末端闭塞症手术治疗体会

目的 回顾性总结主-髂和主-股动脉转流术治疗老年人腹主动脉末端闭塞症的治疗体会，探讨合理的临床治疗方案。方法对收治的27例老年人腹主动脉末端闭塞症的血管转流效果及随访观察结果进行回顾性分析。结果27例手术结束后均能触及股动脉和胭动脉搏动，术后7d患肢缺血症状均得到改善。手术后3个月复查，所有患肢缺血症状消失，且10例阳痿现象得到改善，彩色超声血管吻合口及人工血管内均未见血栓。21例获得1年以上的随访，吻合口通畅率为100．O％；18例获得5年以上随访，吻合口通畅率为83．3％。结论 人工血管主-髂动脉转流和主-股动脉转流是治疗腹主动脉末端闭塞性疾病较好的手术方案，术后合理应用抗凝药物，同时及时处理并发症的发生是提高远期疗效的关键。

The treatment of senile atherosclerosis obliterans of terminal abdominal aorta with bypass grafting

Objective To summarize the clinical data of senile atherosclerosis obliterans of terminal aortic artery treated with bypass grafting. Methods To analyze the results of 27 cases treated with aorti-iliac bypass grafting and aorti-femoral bypass grafting. Results The pulsation of femoral artery and popliteal artery were palpated just after operation. The extremity ischemia signs were disappeared 3 months after operation, and no sign of thrombus was found by color ultrasound in grafting vessel. The results of long-term follow-up were better. The 5-year patency was 83.3% in our data. Conclusions It is a rational and better operated way to treat the senile atherosclerosis obliterans of terminal aortic artery with aorti-iliac bypass grafting and aoti-femoral bypass grafting. It can improve the late curative effects used by giving anticoagulant, antiplatelet aggregation, and by dealing with complication promptly.