腋股旁路术在主髂动脉闭塞性疾病中的应用

发布时间：2018-07-23 19:48

【摘要】：目的:研究腋股动脉旁路术在主髂动脉闭塞性疾病治疗中的作用。探讨腋股动脉旁路术的手术指征、并发症、技术要点以及评价腋股动脉旁路术的疗效。研究对象与方法:回顾性分析2005年10月1日至2016年4月30日行腋股动脉旁路术的45例主髂动脉闭塞性疾病患者的临床资料。其中38例为动脉粥样硬化,6例栓塞,1例夹层。在临床表现上,6例有间歇性跛行,12例有静息痛,27例有溃疡或坏疽。其中26例行腋双股动脉旁路术,19例行腋单侧股动脉旁路术。结果:45例患者最大年龄85岁,最小36岁。男性34例(75.55%),女性11例(24.44%)。年龄、性别、吸烟史、临床表现和并发症与国内外文献报道一致。4例患者出现了术后并发症如轻度肾功能不全和切口延迟愈合。腋双股及腋单股两组中均无死亡病例,因此成功率为100%。术后所有患者的症状都有所减轻,包括静息痛消失、皮肤温度回升。术后随访3-80个月,人工血管通畅率在第1、3、5年分别为93%、87%、81%。结论:腋股动脉旁路术优于其他手术,其手术侵袭性小,创伤小,容易耐受而且有良好的治疗效果,是治疗主髂动脉闭塞性疾病的一种有效方法。
[Abstract]:Objective: to study the role of axillary femoral artery bypass in the treatment of major iliac artery occlusive diseases. Objective: to investigate the indications, complications and technical points of axillary femoral artery bypass surgery and to evaluate the efficacy of axillary femoral artery bypass surgery. Subjects and methods: the clinical data of 45 patients with major iliac artery occlusive disease who underwent axillary femoral artery bypass from October 1, 2005 to April 30, 2016 were retrospectively analyzed. Among them, 38 cases were atherosclerotic embolization in 6 cases and 1 case was dissection. There were 6 cases of intermittent claudication 12 cases of resting pain and 27 cases of ulcer or gangrene. 26 cases were treated by axillary double femoral artery bypass and 19 cases by axillary unilateral femoral artery bypass. Results the maximum age of 45 cases was 85 years old and the youngest was 36 years old. There were 34 males (75.55%) and 11 females (24.44%). Age, sex, smoking history, clinical manifestations and complications were consistent with domestic and international literature in 4 cases of postoperative complications such as mild renal insufficiency and incision delayed healing. There were no death cases in both axillary double-stranded and axillary single-stranded groups, so the success rate was 100%. Symptoms were relieved in all patients after surgery, including the disappearance of resting pain and a rise in skin temperature. After 3-80 months follow-up, the patency rate of artificial blood vessels was 93 / 87 in the first trimester and 83 / 87 in 5 years respectively. Conclusion: axillary femoral artery bypass surgery is superior to other operations. It is less invasive, easily tolerated and has a good therapeutic effect. It is an effective method for the treatment of major iliac artery occlusive diseases.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R654.4
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本文编号：2140460