关键词：动脉闭塞性疾病；小隐静脉；旁路术
摘要 为探讨下肢动脉缺血症旁路重建术新的移植材料，笔者于1992年5月至1997年5月，应用小隐静脉原位旁路术治疗下肢动脉闭塞严重缺血症18例24条肢体并监测随访1～5年。结果：18例近期缺血症状均显著改善，临床有效率达88.8%，远期疗效优良率达83.3%。经寿命表法统计分析，移植物1、3、5年通畅率分别为95.8%，79.6%和70.0%。认为以小隐静脉为移植材料重建缺血肢体循环具有不受长度限制，无需预破坏瓣膜，不必全程结扎属支，避免了反转与扭曲，减少损伤等优点，是一种治疗下肢长段动脉硬化闭塞、血栓闭塞性脉管炎动脉以下3分支闭塞患者理想的术式。
BYPASS OF SMALL SAPHENOUS VEIN IN SITU FOR LOWERLIMB ARTERIAL ISCHEMIA
Wang Chaosheng, Liu Changhua, He Ganxiang, et al.
Department of Vascular Surgery, Affiliated Hospital of Hubei College TCM, Wuhan 430061
Abstract To investigate new graftmaterials for reconstruction of arterial circulation for lower limbs arterial ischemia,authors treated 18 patients with 24 ischemic lower limbs with bypass of small saphenousvein in situ from May, 1992 to May, 1997 who were followed up for one to five years. Theshort-term result showed that ischemic symptoms were improved significantly in 88.8% oflimbs. Good or excellent rate of the long-term result reached 83.3%. The patency rate ofthe graft by the lifetable analysis in 1, 3 and 5 years was 95.8%, 79.6% and 70.0%respectively. We conclude that using small saphenous vein as the graft material toreconstruct the circulation of the ischemic leg is a good operation for long segment ofarteriosclerosis obliterans (ASO) and thromboangiitis obliterans (TAO) with the occlusionof three branches inferior to popliteal artery. It has the advantages of no limit tolength, unnecessarily pre-damaging valves and ligating branches in full courseconsequently to avoid reversion and distortion.
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