Couinaud C, Juin G, Cerceau F, Goddio A S
Sem Hop. 1977 Dec 23;53(44):2553-8.
The authors report 4 cases of hyperlipemia and show the great benefit which results from ileal exclusion when there is an atherogenic risk. The considerable reduction in total lipid, cholesterol, triglycerides, and prebeta-lipoproteins is constant together with clarification of the serum. In one case, angina pectoris regressed considerably, as did arteritis of the lower limbs (unlimited walking became possible, oscillometry in the leg improved from 2 to 7). Surgery is indicated whenever by lack of will power, the diet and medical treatment cannot be followed, when social and economic conditions make proper medical treatment impossible, or when the latter has failed. The existence of arterial lesions, cardiac or cerebral complications makes surgery even more urgent. Gall-stones were observed in gall bladder. The authors raise the problem of oxalate stones. Only type II familial hyperlipemia in homozygotes should be excluded: and end-to-side portacaval anastomosis seems to be preferable.
作者报告了4例高脂血症病例，并表明当存在动脉粥样硬化风险时，回肠切除术带来了巨大益处。总脂质、胆固醇、甘油三酯和前β脂蛋白显著降低，同时血清得以澄清。在1例病例中，心绞痛明显减轻，下肢动脉炎也有所改善（能够不限距离行走，腿部示波测量从2改善至7）。每当因意志力缺乏而无法遵循饮食和药物治疗、社会经济状况使适当的药物治疗无法进行或药物治疗失败时，均应考虑手术。存在动脉病变、心脏或脑部并发症时，手术更为迫切。在胆囊中观察到胆结石。作者提出了草酸盐结石的问题。仅应排除纯合子的II型家族性高脂血症：端侧门腔静脉吻合术似乎更为可取。
