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带蒂大网膜移植用于血栓闭塞性脉管炎肢体挽救

Pedicled omental transfer for limb salvage in Buerger's disease.

作者信息

Talwar S, Jain S, Porwal R, Laddha B L, Prasad P

机构信息

Department of General Surgery, Jawahar Lal Nehru Medical College and Hospital, Ajmer (Rajasthan), India.

出版信息

Int J Cardiol. 2000 Jan 15;72(2):127-32. doi: 10.1016/s0167-5273(99)00179-5.

Abstract

We performed pedicled omental transfer in 62 patients with Buerger's disease at the Department of Surgery, J.L.N. Hospital, Ajmer between January 1990 and December 1996. All were male and had evidence of limb ischaemia. Post-operative results in these patients consisted of relief of intermittent claudication in 92%, disappearance of rest pain in 94%, disappearance of limb coldness in 83%, disappearance of discolouration in 82%, and healing of ischaemic ulcers in 83%. Tissue oxygen saturation in the affected limb improved from a mean of 84.8+/-3.6% in the preoperative period, to 89+/-1.5% at 12 h, 93.1+/-1.8% at 72 h and 96+/-1.2% at the end of 2 months of follow-up. Claudication distance improved from a mean of 75+/-20 m in the pre-operative period to 1000+/-110 m at 2 months of follow-up in 57 of 62 patients. Major amputations were not required in any patient, thus conserving the limb. We conclude that pedicled omental transfer offers promising results in patients with limb ischaemia due to Buerger's disease.

摘要

1990年1月至1996年12月期间,我们在阿杰梅尔J.L.N.医院外科为62例伯格氏病患者进行了带蒂大网膜移植术。所有患者均为男性,并有肢体缺血的证据。这些患者的术后结果包括:92%的患者间歇性跛行得到缓解,94%的患者静息痛消失,83%的患者肢体发冷消失,82%的患者肢体变色消失,83%的患者缺血性溃疡愈合。患侧肢体的组织氧饱和度从术前的平均84.8±3.6%提高到术后12小时的89±1.5%、72小时的93.1±1.8%以及随访2个月末的96±1.2%。62例患者中有57例的跛行距离从术前的平均75±20米增加到随访2个月时的1000±110米。所有患者均无需进行大截肢,从而保住了肢体。我们得出结论,带蒂大网膜移植术为因伯格氏病导致肢体缺血的患者提供了有前景的治疗结果。

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