| 耿家威,胡何节,方征东,王晓天,孙小杰.下肢动脉血管旁路移植术后再闭塞的影响因素分析[J].中国临床保健杂志,2017,20(4):349-352. |
| 下肢动脉血管旁路移植术后再闭塞的影响因素分析 |
| Multivariate analysis of prosthetic graft occlusion after lower extremity bypasses |
| 投稿时间：2016-12-22 |
| DOI：10.3969/J.issn.1672-6790.2017.04.004 |
| 中文关键词: 闭塞性动脉硬化 血管移植术 下肢 复发 危险因素 |
| 英文关键词: Arteriosclerosis obliterans Vascular grafting Lower extremity Recurrence Risk factors〖FL |
| 基金项目:安徽省自然科学基金(1408085MH177) |
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| 中文摘要: |
| 目的 分析影响下肢动脉血管旁路移植术后再闭塞的危险因素。方法 回顾性分析80例下肢动脉粥样硬化闭塞症患者血管旁路移植术的临床资料,术后1、3、6、9、12个月以及以后每半年复查下肢血管B超、CT血管造影检查,必要时行数字减影血管造影(DSA)检查。对术后血管闭塞发展情况进行分析总结,探讨影响下肢动脉血管旁路移植术后再闭塞的因素。结果 手术成功率100%(80/80),围手术期1例病例因术后突发急性脑梗死脑疝死亡,80例患者中首次术式:股动脉—腘动脉(膝上)血管搭桥术62例(77.5%),股动脉—腘动脉(膝下)血管搭桥术18例(22.5%),其中9例使用自体大隐静脉(11.2%),12例使用直径6 mm人工血管(15%),59例使用直径8 mm人工血管(73.8%)。41例患者合并高血压(51.2%),16例患者合并糖尿病(20%),13例患者合并心脏疾病病(16.2%),9例患者合并脑血管病史(11.2%)。随访率为86.9%(80/92),随访时间为1~60个月,随访期病死率为11.2%(9/80)。术后闭塞37例(46.2%),术后通畅43例(53.8%),术后死亡病例9例,其中2例死于突发脑梗死,3例死于脑出血,其余4例死于心血管疾病。结论 糖尿病、术前评估流出道小于2根、术中选择直径6 mm人工血管和行膝下搭桥手术是患者术后再闭塞的危险因素。 |
| 英文摘要: |
| Objective To summarize the recovery of lower extremity artery bypass surgery by analyzing the cases treated in our department,and to explore the influencing factors of graft occlusion after lower extremity arterial bypass;for lower extremity arteriosclerosis obliterans patients with lower extremity vascular bypass effect with evidence-based medicine. Methods A retrospective analysis of the clinical data of 80 cases of lower extremity atherosclerosis was performed ,cases were followed by 1,3,6,9,12 M,and thereafter,every half year review of lower extremity vascular ultrasound,CTA examination,DSA examination if necessary.tosummarize the development of postoperative vascular occlusion,and to explore the factors that affect the re occlusion after arterial bypass grafting. Results The success rate of operation was 100% (80/80),one died of sudden death of acute cerebral infarction with cerebral hernia。During perioperative case phase first operation of 80 cases were distributed as follows:the femoral artery,popliteal artery (knee) in 62 cases of vascular bypass (77.5%),femoral artery and popliteal artery (knee) in 18 cases of vascular bypass (22.5%),including 9 cases using autologous saphenous vein (11.2%),12 cases with 6mm diameter artificial blood vessel (15%),59 cases with 8mm diameter artificial blood vessel (73.8%).All the 80 patients were followed up.41 patients with hypertension (51.2%),16 cases of patients with diabetes mellitus (20%),13 cases of patients with heart disease (16.2%),9 cases of patients with cerebral vascular disease (11.2%) were recorded.Postoperative occlusion occurred in 37 cases (46.2%)and postoperative patency in 43 cases (53.8%).Conclusions The risk of occlusion is higher in the patients with diabetes mellitus before operation,which are the ePTFE graft of 6mm in diameter,femoral-popliteal bypass(below knee) or the number of outflow less than two. |
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