主动脉-髂动脉搭桥术后缺血性腰骶丛神经病：病例报告及文献复习

Ischaemic lumbosacral plexopathy following aorto-iliac bypass graft: case report and review of literature.

作者信息

Abdelhamid Mohamed Farouk, Sandler Belinda, Awad Reda William

机构信息

General Surgery Department, Watford General Hospital, Watford, Hertfordshire, UK.

出版信息

Ann R Coll Surg Engl. 2007 Jul;89(5):W12-3. doi: 10.1308/147870807X188470.

DOI:10.1308/147870807X188470

PMID:17688710

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2048625/

Abstract

A 77-year-old man had aorto-iliac bypass for an abdominal aortic aneurysm (AAA). This was complicated by occlusion that needed extension of the graft to the right femoral artery. He was unable to move his right leg with numbness after surgery. This was caused by extensive lumbosacral plexopathy on the right side. Lumbosacral plexopathy is uncommon because the plexus has a rich blood supply. The incidence of ischaemic lumbosacral plexopathy is higher with re-operative and emergency AAA reconstruction. This may predispose the lumbosacral plexus to ischaemic injury. Consideration should be given to maintaining retrograde perfusion of the internal iliac artery.

摘要

一名77岁男性因腹主动脉瘤（AAA）接受了主-髂动脉搭桥手术。术后出现并发症，血管闭塞，需要将移植物延伸至右股动脉。术后他无法移动右腿且伴有麻木感。这是由右侧广泛的腰骶丛病变所致。腰骶丛病变并不常见，因为该神经丛血供丰富。再次手术和急诊AAA重建时，缺血性腰骶丛病变的发生率更高。这可能使腰骶丛易发生缺血性损伤。应考虑维持髂内动脉的逆行灌注。