Otterstad Jan Erik, Strøm Odd
Medisinsk avdeling Sentralsykehuset i Vestfold 3116 Tønsberg.
Tidsskr Nor Laegeforen. 2002 Jan 20;122(2):172-3.
Thromboangiitis obliterans (Buerger's disease) is characterised by inflammatory thrombi in small and middle-sized arteries and in the veins. As opposed to arteriosclerosis, the vessel wall remains normal. Diagnostic criteria are the presence of distal ischaemia in the extremities, documented by noninvasive vascular testing; exclusion of autoimmune diseases, hypercoagulable states, and diabetes mellitus, age less than 45 years and cigarette smoking.
The article is based on a case history and review of the literature.
A 31-year-old man was in 1953 diagnosed with thromboangiitis obliterans. Lumbar sympathectomy on the left side in 1953 and on the right side in 1971 had excellent symptomatic effect. The patient has been treated with anticoagulants for 48 years. Amputation of the left 2nd toe was performed in 1971. At age 80, he is without further cardiovascular events and takes regular physical exercise. Over the last fifty years, the incidence of thromboangiitis obliterans has been drastically reduced. The reason for this is unknown. The only proven treatment is complete discontinuation of tobacco. The effect of sympathectomy and long-term anticoagulation has not been proven.
血栓闭塞性脉管炎（伯格氏病）的特征是中小动脉和静脉出现炎性血栓。与动脉硬化不同，血管壁保持正常。诊断标准包括通过无创血管检测证实的肢体远端缺血；排除自身免疫性疾病、高凝状态和糖尿病，年龄小于45岁且有吸烟史。
本文基于病例报告及文献综述。
一名31岁男性于1953年被诊断为血栓闭塞性脉管炎。1953年行左侧腰交感神经切除术，1971年行右侧腰交感神经切除术，症状改善明显。该患者接受抗凝治疗已48年。1971年行左足第2趾截肢术。80岁时，他未再发生心血管事件，且坚持规律体育锻炼。在过去五十年中，血栓闭塞性脉管炎的发病率已大幅下降。原因不明。唯一经证实有效的治疗方法是完全戒烟。交感神经切除术和长期抗凝治疗的效果尚未得到证实。
