摘要：目的：探讨大隐静脉交叉转流术治疗髂-股静脉闭塞症的适应证、禁忌证、手术方法及疗效。方法：采用大隐静脉交叉转流术治疗髂-股静脉闭塞症12例。取自体大隐静脉作耻骨上交叉转流并建立临时性动静脉瘘，术中及术后辅以溶栓抗凝药物治疗，术后3个月结扎临时性动静脉瘘。结果：随访10例，随访时间最长42个月，最短5个月，平均31.6个月。7例转流静脉通畅，临床症状消失，有效率70%；3例闭塞，但未出现溃疡等严重并发症。结论：大隐静脉交叉转流术术后大隐静脉通畅率较低，但结合临时性动静脉瘘手术，仍不失为治疗髂-股静脉闭塞症的有效手术。

    关键词：髂-股静脉闭塞；大隐静脉交叉转流术；临时性动静脉瘘

    Study of Cross Over Great Saphena in Surgical Treatment of Iliofermoral Venous Occlusion

    TIAN Ming-xia, ZHANG Yi, WANG Sheng-jia

    (Department of Vascular Surgery,Qingdao Shinan District People’s Hospital,Shandong Qingdao 266002, China)

    Abstract： Objective： To study indication,precedure and efficacy of cross over great saphena in surgical treatment of iliofermoral venous occlusion. Methods： Seven patients with iliofermoral venous occlusion were treated by operation of cross over great saphena.Operation of cross over above pubis was done by using autogenous great saphena besides building temporary areriovenous fistula.Inaddition,thrombolytic and anticoagulant therapy must also be given in and post operation. The temporary arteriovenous(A-V) fistula would be closed three monthes after operation. Results: 10 (70%) of all 11 patients were followed up for 5 to 42 months(mean 31.6 months).Shunted great saphena were unobstructed and the preoperational symptoms were disappeared in 7 patients.Although 3 patients failed as the great saphena had thrombosed, the preoperational symptoms were disappeared in these three patients after the temporary arteriovenous(A-V) fistula had closed 3 monthes later. There were no complications.Conclusion: Although the operation of cross over great saphena had a lower unobstructed rate in saphena,it’s also an effective therapy if combined with building temporary areriovenous fistula at the same time of operation in surgical treatment of iliofermoral venous occlusion. ......