Salimi Javed, Tavakkoli Hasan, Salimzadeh Ahmad, Ghadimi Hadi, Habibi Gholamreza, Masoumi Amir Ali
Department of Surgery, Sina Hospital, Medical Sciences / University of Tehran, Tehran, Iran.
J Coll Physicians Surg Pak. 2008 Aug;18(8):502-5.
To determine the clinical course of Buerger's disease as observed in two vascular surgery centers located in the capital of Iran.
Case series.
Sina and Imam Hospitals, Tehran, Iran, during the years 1997 to 2002.
The records of all the patients admitted with Buerger's disease diagnosed on the basis of Shionoya's clinical criteria were studied. Their clinical characteristics, treatment offered and short-term follow-up results are described as frequencies and percentages.
A total of 116 patients, aged 41.1+/-11.3 years, were enrolled. All patients were males; 99% of them were smokers with an average of 22.9 pack-years of tobacco use. Lower-extremity was affected in 102 (87.9%) patients, upper-extremity in 3 (2.6%) patients and both in 11 (9.5%). The most frequent reasons for being referred to hospital were ischemic ulcers (90.5%), claudication (87.9%), paresthesia (75.9%), rest pain (66.4%), gangrene (60.3%), Raynaud's phenomenon (23.3%) and thrombophlebitis (9.5%). Diagnostic arteriography, vascular bypass surgery and sympathectomy were performed in 60%, 24% and 83% of the patients, respectively. Sixty-eight patients (58.6%) had one of the following amputations: toe 36 (52.9%), transmetatarsal 3 (4.4%), below knee 25 (36.8%), finger 3 (4.4%) and above knee one (1.5%) patient.
Since the studied hospitals are the referral centers for vascular surgery in Iran admitting patients with severe symptoms; therefore, a higher number of complications and amputations was found in the present study. Upper extremity involvement as well as the occurrence of thrombophlebitis and Raynaud's phenomenon was rather infrequent among the studied cases.
确定在伊朗首都的两个血管外科中心观察到的血栓闭塞性脉管炎的临床病程。
病例系列。
1997年至2002年期间，伊朗德黑兰的西纳医院和伊玛目医院。
研究所有根据盐谷临床标准诊断为血栓闭塞性脉管炎的住院患者的记录。描述他们的临床特征、所接受的治疗以及短期随访结果的频率和百分比。
共纳入116例患者，年龄41.1±11.3岁。所有患者均为男性；其中99%为吸烟者，平均吸烟量为22.9包年。102例（87.9%）患者下肢受累，3例（2.6%）患者上肢受累，11例（9.5%）患者上下肢均受累。入院最常见的原因是缺血性溃疡（90.5%）、间歇性跛行（87.9%）、感觉异常（75.9%）、静息痛（66.4%）、坏疽（60.3%）、雷诺现象（23.3%）和血栓性静脉炎（9.5%）。分别有60%、24%和83%的患者进行了诊断性血管造影、血管搭桥手术和交感神经切除术。68例患者（58.6%）进行了以下截肢手术之一：脚趾截肢36例（52.9%）、经跖骨截肢3例（4.4%）、膝下截肢25例（36.8%）；手指截肢3例（4.4%）；大腿截肢1例（1.5%）。
由于所研究的医院是伊朗血管外科的转诊中心，收治症状严重的患者；因此，本研究中发现并发症和截肢的数量较多。在所研究的病例中，上肢受累以及血栓性静脉炎和雷诺现象的发生较为罕见。
