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[糖尿病患者下肢远端动脉闭塞的自体静脉搭桥术]

[The autovenous by-pass by distal arterial occlusion of lower limbs in patients with diabetes mellitus].

作者信息

Kolobova O I, Subbotin Iu G, Kozlov A V, Arzamastsev D D

出版信息

Khirurgiia (Mosk). 2011(7):18-23.

Abstract

Results of the autovenous by-pass in situ by distal combined arterial occlusion of femoral-popliteal and ankle arterial segments were analyzed. The main group consisted of 43 patients with diabetes mellitus and lower limbs ischemia grade IV in 81,4%. The comparison group consisted of 77 patients without diabetes and critical lower limbs ischemia in 84,4%. The 30 days by-pass patency was 90,5% in diabetic patients; whereas in the absence of diabetes mellitus the patency rate was 89%. There were no significant difference between two groups within the 2 years following the operation. After 3 postoperative years patients with diabetes showed poorer results: cumulative by-pass patency was 45,4%, limb preservation rate was 58,7%, whereas the relevant rates in the control group were 49,6 and 87,9%, respectively. The hemodynamic features of the by-pass make it suitable for the patients with diabetes mellitus and arterial occlusion by the diabetic foot syndrome.

摘要

分析了通过股腘动脉和踝动脉节段远端联合动脉闭塞进行原位自体静脉搭桥术的结果。主要组由43例糖尿病患者组成,其中81.4%为下肢IV级缺血。对照组由77例无糖尿病且84.4%为下肢严重缺血的患者组成。糖尿病患者30天搭桥通畅率为90.5%;而无糖尿病患者的通畅率为89%。术后2年内两组之间无显著差异。术后3年,糖尿病患者的结果较差:累积搭桥通畅率为45.4%,肢体保留率为58.7%,而对照组的相应比率分别为49.6%和87.9%。搭桥术的血流动力学特征使其适用于糖尿病患者和因糖尿病足综合征导致动脉闭塞的患者。

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