下肢血栓闭塞性脉管炎影像学分型及临床意义
发布时间：2018-10-11 19:22
【摘要】：目的:初步探讨下肢血栓闭塞性脉管炎的影像学分型及临床意义方法:回顾性分析新疆维吾尔族自治区人民医院血管外科2006年1月~2014年1月下肢血栓闭塞性脉管炎84例患者影像及临床资料,其中54例行血管重建术,13例行自体大隐静脉搭桥术[其中4例行髂股动脉搭桥术、4例行膝上股乆动脉搭桥术,5例为膝下动脉搭桥术(3例为胫前动脉、2例为胫后动脉)],14例行球囊扩张术联合置管溶栓术(髂股段1例、股乆段8例、膝下段5例),4例行球囊扩张联合支架置入术(髂股段2例、股乆段2例),23例行动脉切开取栓术联合干细胞移植术(髂股段2例、股乆段8例、膝下段13例)。结果:影像资料示大致分为髂股型、股乆型、膝下型。38例手术效果基本满意,16例手术无效,分别为4例行自体大隐静脉搭桥术、1例行球囊扩张联合支架置入术、4例行球囊扩张联合置管溶栓术、7例行动脉切开取栓术联合干细胞移植术。围手术期2例行膝上截肢术,3例行膝下截肢术,11例行截趾术。随访3月至40月,平均(16+12)月。总体手术成功率70.4%,术后6个月通畅率50%(24/48),12个月通畅率64.6%(31/48)。结论:根据临床影像资料分析,我们大致将下肢血栓闭塞性脉管炎分为三型,即髂股型、股乆型、膝下型,其中髂股型少见,大多有良好远端流出道。股乆型、膝下型常见,闭塞平面下多无良好远端流出道。因此根据患者的血管情况选择不同的术式,对于有良好远端流出道的患者,首选自体大隐静脉搭桥术,无良好远端流出道的患者可选择球囊扩张术,疗效尚可。对于慢性患者急性血栓形成的患者动脉切开取栓联合干细胞移植是一种可行、有效的方法。
[Abstract]:Objective: to study the imaging classification and clinical significance of thromboocclusive vasculitis of lower extremity: retrospective analysis of vascular occlusion of lower extremity thrombosis in Xinjiang Uygur Autonomous region people's Hospital from January 2006 to January 2014 Imaging and clinical data of 84 patients with inflammation, Of these, 54 underwent revascularization, 13 major saphenous vein autograft [4 iliofemoral artery bypass grafting, 4 superior genicular femoral artery bypass grafting, 5 inferior genicular artery bypass grafting (3 anterior tibial artery and 2 posterior tibial artery bypass grafting) 14 cases underwent balloon dilatation combined with catheter thrombolysis (1 case of iliofemoral segment). There were 8 cases of femoral segment, 5 cases of lower genu segment, 4 cases of balloon dilation combined with stent implantation (2 cases of iliofemoral segment, 2 cases of femoral segment), 23 cases of artery incision and embolization combined with stem cell transplantation (2 cases of iliofemoral segment, 8 cases of femoral segment and 13 cases of lower genu segment). Results: the imaging data showed that there were three types: iliofemoral type, femoral type, subgenu type, 38 cases were satisfactory, 16 cases were ineffective. There were 4 cases of autologous saphenous vein bypass grafting, 1 case of balloon dilatation combined with stent implantation, 4 cases of balloon dilation combined with catheter thrombolysis, and 7 cases of artery incision and embolization combined with stem cell transplantation. During the perioperative period, 2 cases were treated with superior knee amputation, 3 cases with subknee amputation, and 11 cases with toe amputation. The follow-up ranged from 3 months to 40 months, with an average of 16 12 months. The overall success rate of operation was 70.4. The patency rate was 50% (24 / 48) at 6 months postoperatively and 64.6% (31 / 48) at 12 months. Conclusion: according to the analysis of clinical imaging data, we divide the thrombosis obliterative vasculitis of lower extremity into three types, namely, iliofemoral type, femoral type and subgenu type, among which iliofemoral type is rare, and most of them have good distal outflow tract. There is no good distal outflow tract under obliterated plane. Therefore according to the blood vessel condition of the patients choose different operation methods for patients with good distal outflow the first choice is autologous saphenous vein bypass surgery without good distal flow out of the patients can choose balloon dilatation the curative effect is good. It is a feasible and effective method for patients with chronic acute thrombosis.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.3
本文编号：2264973
[Abstract]:Objective: to study the imaging classification and clinical significance of thromboocclusive vasculitis of lower extremity: retrospective analysis of vascular occlusion of lower extremity thrombosis in Xinjiang Uygur Autonomous region people's Hospital from January 2006 to January 2014 Imaging and clinical data of 84 patients with inflammation, Of these, 54 underwent revascularization, 13 major saphenous vein autograft [4 iliofemoral artery bypass grafting, 4 superior genicular femoral artery bypass grafting, 5 inferior genicular artery bypass grafting (3 anterior tibial artery and 2 posterior tibial artery bypass grafting) 14 cases underwent balloon dilatation combined with catheter thrombolysis (1 case of iliofemoral segment). There were 8 cases of femoral segment, 5 cases of lower genu segment, 4 cases of balloon dilation combined with stent implantation (2 cases of iliofemoral segment, 2 cases of femoral segment), 23 cases of artery incision and embolization combined with stem cell transplantation (2 cases of iliofemoral segment, 8 cases of femoral segment and 13 cases of lower genu segment). Results: the imaging data showed that there were three types: iliofemoral type, femoral type, subgenu type, 38 cases were satisfactory, 16 cases were ineffective. There were 4 cases of autologous saphenous vein bypass grafting, 1 case of balloon dilatation combined with stent implantation, 4 cases of balloon dilation combined with catheter thrombolysis, and 7 cases of artery incision and embolization combined with stem cell transplantation. During the perioperative period, 2 cases were treated with superior knee amputation, 3 cases with subknee amputation, and 11 cases with toe amputation. The follow-up ranged from 3 months to 40 months, with an average of 16 12 months. The overall success rate of operation was 70.4. The patency rate was 50% (24 / 48) at 6 months postoperatively and 64.6% (31 / 48) at 12 months. Conclusion: according to the analysis of clinical imaging data, we divide the thrombosis obliterative vasculitis of lower extremity into three types, namely, iliofemoral type, femoral type and subgenu type, among which iliofemoral type is rare, and most of them have good distal outflow tract. There is no good distal outflow tract under obliterated plane. Therefore according to the blood vessel condition of the patients choose different operation methods for patients with good distal outflow the first choice is autologous saphenous vein bypass surgery without good distal flow out of the patients can choose balloon dilatation the curative effect is good. It is a feasible and effective method for patients with chronic acute thrombosis.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R654.3
【参考文献】
中国期刊全文数据库 前3条
1 王嘉桔;赵文光;孙思翘;张阳;;血栓闭塞性脉管炎的发病变迁(百年回顾之一)[J];中国血管外科杂志(电子版);2009年01期
2 金星;张大伟;李昭辉;杨文涛;张精勇;薛智军;孟红;张勇;刘秀云;;血栓闭塞性脉管炎动物模型研究[J];医学研究通讯;2002年11期
3 肖善文,王庆华,胡存义,房巍;腰交感神经节切除治疗下肢血栓闭塞性脉管炎临床观察[J];中国综合临床;2000年02期
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