解剖外腋_股_股_股动脉旁路移植术治疗主髂动脉闭塞症.docVIP

解剖外腋_股_股_股动脉旁路移植术治疗主髂动脉闭塞症 　　采用解剖外旁路移植术治疗主髂动脉闭塞症患者 32 例 。18 例腹主动脉或两侧髂动脉闭塞者采用腋2 股动脉旁路术 ,其中 2 例为腋2两股动脉旁路术 ;14 例单侧髂动脉闭塞者采用股2对侧股动脉旁路术 。 　　( ) 采用腋2股动脉旁路的患者 ,术中 8 例用真丝人造血管移植 ,10 例用聚四氟乙烯 Gore2Tex人造血管 ; 股2股动脉旁路术中 6 例用真丝人造血管移植 ,1 例用自体大隐静脉 ,7 例用 Gore2Tex 人造血管 。 结 果 术后 5 年随访时 ,股2股动脉旁路术通畅率为 78 % ,其中真丝人造血管与 Gore2Tex 人造血管通畅 率无明显差异 ; 腋2股动脉旁路术中 ,8 例真丝人造血管均已闭塞 ,10 例 Gore2Tex 人造血管中 1 例闭 塞 ,1 例发生腹股沟部假性动脉瘤 。 结论 解剖外动脉旁路移植术操作简单 ,创伤小 ,无腹部手术并 发症 ,手术安全 ,术后恢复快 。真丝人造血管的使用应限于短段的股2股动脉旁路术 。 　　【关键词】 血管成形术人工血管动脉闭塞性疾病 　　Extra2anatomy axillary2f emoral or f emoro2f emoral bypass graf ting f or the treatment of aorta2il iac occlu2 sive disease Ye J i an rong , W an g Y uqi , Fan L ongh u a ,et al . V ascul a r S u rgery , Zhongs han Hos pi t al , S hang2 hai M edical U ni versi ty , S hanghai 200032 . 　　【Abstract】 Objective To st udy t he result of ext ra2anato my axillary2femoral or femoro2femoral by2 pass graf ting which was performed to t reat aorta2iliac arterial occlusive disease. Method Fro m 1978 t hroug 1997 , 32 patient s wit h aorta2iliac occlusive disease underwent ext ra2anato my axillary2femoral or femoro2femoral bypass graf ting at our hospital . Eighteen patient s wit h aorta or bilateral iliac artery occlusive 　　( ) lesio n underwent axillary2femoral artery bypass , including axillary2bifemoral artery bypass 2 patient s. Fourteen patient s wit h o ne side iliac arterial occlusive lesio n received femoro2femoral bypass graf ting. In who had had axillary2femoral artery bypass 18 patient s , 8 received ,p ure sil k p rost hesis ,and 10 Gore2Tex p ros2 t hesis. In femoro2femoral arterial bypass ,p ure sil k p rost hesis was given to 8 patient s ,sap henous vein to o ne , and Gore2Tex p rost hesis to 7 . Result Follow2up for 5 years , a patency rate of 78 % was achieved in femoro2femoral artery bypass , in which no different patency rate was found bet ween p ure sil k p rost hesis and Gore2Tex p rost hesis. In axillary2femoral bypass , eight p ure sil