Głowiński S, Wołczyński Z, Buzun L, Kondracki S, Ostapowicz J
Kliniki Chirurgii Naczyń i Transplantacji AM, Bialymstoku.
Pol Tyg Lek. 1992;47(18-19):407-11.
The study was carried out within a multicenter program. Hundred fifty four patients under 40 years were treated (73 conservatively, and 81 surgically) for the atheromatous ischemia of the lower limbs in 14 Departments of Vascular Surgery in Poland within 5 years. The results of the treatment were evaluated according to the site of atheromatous lesions, type of surgery, and mainly according to the progress in pathologic process expressed by the degree of limb ischemia. It was found that surgery performed in the II period of the disease produces the best results. Surgery produces positively better results than conservative treatment in patients with the II period of the disease whereas both surgical and conservative therapy are ineffective in the III and IV degrees of ischemia. Sympathectomy may be effective in the occlusion of crural arteries even of the IV degree ischemia. In case of the II degree ischemia better results are produced by the operation of aorto-iliaco-femoral segment (transplantation or thrombendarterectomy) than that involving distal segment (sympathectomy) whereas the results of conservative therapy are better in peripheral and iliaco-femoral occlusion than those in aortofemoral and multisegmental arterial occlusion. An opinion of several authors on the specificity of atheromatous ischemia of the lower limbs in young patients was not confirmed.
该研究是在一个多中心项目中进行的。在波兰14个血管外科科室，5年内对154例40岁以下患有下肢动脉粥样硬化性缺血的患者进行了治疗（73例采用保守治疗，81例采用手术治疗）。根据动脉粥样硬化病变部位、手术类型，主要是根据肢体缺血程度所反映的病理过程进展来评估治疗结果。结果发现，在疾病的II期进行手术效果最佳。对于处于疾病II期的患者，手术效果明显优于保守治疗；而在III度和IV度缺血时，手术和保守治疗均无效。交感神经切除术对于股动脉闭塞甚至IV度缺血可能有效。在II度缺血的情况下，主-髂-股段手术（移植或血栓内膜切除术）比涉及远端段的手术（交感神经切除术）效果更好；而在周围和髂-股动脉闭塞时，保守治疗的效果优于主-股动脉和多节段动脉闭塞时的效果。几位作者关于年轻患者下肢动脉粥样硬化性缺血特异性的观点未得到证实。
