【摘要】：目的:研究腋股動脈旁路術(shù)在主髂動脈閉塞性疾病治療中的作用。探討腋股動脈旁路術(shù)的手術(shù)指征、并發(fā)癥、技術(shù)要點以及評價腋股動脈旁路術(shù)的療效。研究對象與方法:回顧性分析2005年10月1日至2016年4月30日行腋股動脈旁路術(shù)的45例主髂動脈閉塞性疾病患者的臨床資料。其中38例為動脈粥樣硬化,6例栓塞,1例夾層。在臨床表現(xiàn)上,6例有間歇性跛行,12例有靜息痛,27例有潰瘍或壞疽。其中26例行腋雙股動脈旁路術(shù),19例行腋單側(cè)股動脈旁路術(shù)。結(jié)果:45例患者最大年齡85歲,最小36歲。男性34例(75.55%),女性11例(24.44%)。年齡、性別、吸煙史、臨床表現(xiàn)和并發(fā)癥與國內(nèi)外文獻報道一致。4例患者出現(xiàn)了術(shù)后并發(fā)癥如輕度腎功能不全和切口延遲愈合。腋雙股及腋單股兩組中均無死亡病例,因此成功率為100%。術(shù)后所有患者的癥狀都有所減輕,包括靜息痛消失、皮膚溫度回升。術(shù)后隨訪3-80個月,人工血管通暢率在第1、3、5年分別為93%、87%、81%。結(jié)論:腋股動脈旁路術(shù)優(yōu)于其他手術(shù),其手術(shù)侵襲性小,創(chuàng)傷小,容易耐受而且有良好的治療效果,是治療主髂動脈閉塞性疾病的一種有效方法。
[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.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R654.4
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本文編號：2140460