Kuznetsov M R, Rodionov S V, Koshkin V M, Virganskiĭ A O, Golosnitskiĭ P Iu, Tepliakov S A, Kosykh I V, Ostapchuk N A, Lisenkov O P, Chernikov V P
Angiol Sosud Khir. 2011;17(2):23-9.
The study comprised a total of 107 patients (all men) after endured femoropopliteal bypass grafting above the genicular fissure with a synthetic stent graft manufactured by the Gore Company for stage IIB and III chronic arterial insufficiency of the lower extremities according to the Fontain-Pokrovsky classification. Group One I (control group) was composed of fifty-four patients permanently taking in the postoperative period at the out-patient stage pentoxiphylline (trental 400 mg 1 tablet 3 times daily) and xantinol nicotinate at a dose of 150 mg one tablet thrice daily. Group Two (Study Group) consisted of fifty-three patients taking after reconstructive vascular surgery at the out-patient stage in addition to pentoxiphylline and xantinol nicotinate acetylsalicylic acid (cardiomagnil 75 mg 1 tablet once daily). The Control Group patients within 3 to 6 months of follow up were found to have a considerable progressing improvement of the functional abilities of the microcirculatory bed requiring in 44 (81.5%) cases hospitalization to the Surgical Department for intensive vascular therapy. Despite this fact four (7.4%) patients within the time frame from 6 to 9 months after surgery developed thrombosis of the vascular implant requiring a repeat surgical intervention. In the Study Group patients, the degree of functional capabilities of the microcirculatory bed in the postoperative period was less considerable, reaching the maximum after 10-12 months of follow up, with eighteen (34.0%) patients requiring hospitalization for additional vascular therapy to perform. There were no cases of implants' thrombosis in the Study Group patients. Pathological alterations in the functional state of the peripheral vascular bed correlated with viscosimetric indices and activity of blood platelet aggregation. The addition of antithrombocytic agents to conservative postoperative therapy considerably improved the outcomes of surgical treatment.
该研究共纳入107例患者（均为男性），这些患者根据Fontain-Pokrovsky分类法，因IIB期和III期下肢慢性动脉功能不全，在膝部裂隙上方接受了戈尔公司生产的合成支架移植物进行的股腘动脉搭桥手术。第一组（对照组）由54例患者组成，他们在门诊阶段术后长期服用己酮可可碱（曲克芦丁400毫克，每日3次，每次1片）和烟胺羟丙茶碱，剂量为每日3次，每次1片，150毫克。第二组（研究组）由53例患者组成，他们在门诊阶段血管重建手术后，除服用己酮可可碱和烟胺羟丙茶碱外，还服用乙酰水杨酸（心脉宁75毫克，每日1次，每次1片）。对照组患者在随访3至6个月时，发现微循环床功能能力有相当大的进展性改善，44例（81.5%）患者需要住院到外科进行强化血管治疗。尽管如此，仍有4例（7.4%）患者在术后6至9个月内发生血管植入物血栓形成，需要再次进行手术干预。在研究组患者中，术后微循环床功能能力的程度较低，在随访10至12个月后达到最大值，18例（34.0%）患者需要住院进行额外的血管治疗。研究组患者中没有植入物血栓形成的病例。外周血管床功能状态的病理改变与粘度指数和血小板聚集活性相关。在术后保守治疗中添加抗血栓药物可显著改善手术治疗效果。
