Ates Azman, Yekeler Ibrahim, Ceviz Münacettin, Erkut Bilgehan, Pac Mustafa, Basoglu Ahmet, Kocak Hikmet
Department of Cardiovascular Surgery, Atatürk University School of Medicine, Erzurum, Turkey.
Int J Cardiol. 2006 Jul 28;111(1):147-53. doi: 10.1016/j.ijcard.2005.12.002. Epub 2006 Mar 6.
This is a retrospective clinical study on adult patients treated surgically for Buerger's disease in our region.
In our clinic, 344 patients with Buerger's disease were surgically treated between 1980 and 2004. The major complaints included foot coldness in 312 (90.6%) patients, color changes in 290 (84.3%), rest pain in 160 (46.5%), claudication in 166 (48.2%) and necrotic ulcers in 185 (53.1%). Lumbar sympathectomy was made in 278 (80.2%) patients, thoracic sympathectomy in 7 (2.2%), thoracic and lumbar sympathectomy in 12 (3.6%), lumbar sympathectomy and femoropopliteal or femorotibial bypass in 30 (9%), and femoropopliteal or femorotibial bypass in 17 (5%).
Color changes were improved in 230 (79.3%) patients, food coldness were decreased in 288 (92.3%) and rest pains were improved in 43 (26.8%). Intermittent claudications decreased in 132 of 166 patients. Necrotic ulcers healed in 30 of 185 patients. Amputation was made totally in 155 (53%) patients in 10 years.
As a nonatherosclerotic, segmental, inflammatory disease, Buerger's disease is casually related to tobacco use. The main goal is to discontinue the use of tobacco. Sympathectomy may be helpful in healing the ulcers and decreasing the symptoms. Vascular reconstruction is rarely possible for patients with Buerger's disease due to segmental involvement and distal nature of the disease.
这是一项针对本地区接受手术治疗的布加氏病成年患者的回顾性临床研究。
在我们诊所，1980年至2004年间对344例布加氏病患者进行了手术治疗。主要症状包括312例（90.6%）足部发冷、290例（84.3%）肤色改变、160例（46.5%）静息痛、166例（48.2%）间歇性跛行以及185例（53.1%）坏死性溃疡。278例（80.2%）患者接受了腰交感神经切除术，7例（2.2%）接受了胸交感神经切除术，12例（3.6%）接受了胸腰交感神经切除术，30例（9%）接受了腰交感神经切除术加股腘或股胫旁路手术，17例（5%）接受了股腘或股胫旁路手术。
230例（79.3%）患者的肤色改变得到改善，288例（92.3%）患者的足部发冷症状减轻，43例（26.8%）患者的静息痛得到改善。166例间歇性跛行患者中有132例症状减轻。185例坏死性溃疡患者中有30例愈合。10年间共有155例（53%）患者接受了截肢手术。
作为一种非动脉粥样硬化性、节段性、炎症性疾病，布加氏病与吸烟有因果关系。主要目标是戒烟。交感神经切除术可能有助于溃疡愈合并减轻症状。由于疾病的节段性累及和远端性质，布加氏病患者很少能够进行血管重建。
