Patwa Jagdish Jashwantlal, Krishnan Ajay
Indian J Surg. 2011 Jan;73(1):40-7. doi: 10.1007/s12262-010-0186-1. Epub 2010 Dec 14.
In Buerger's disease conservative treatment is questionable. Arterial reconstructive surgery is not feasible and sympathectomy has limited role. Progression of the disease invariably leads to amputation. Ilizarov's method increases the vascularity of the ischaemic limb. Retrospective analysis of Ilizarov's technique in 60 patients was done. Immediate results took into account rest pain, colour of skin, venous return, temperature, pulse oxymeter measured oxygen saturation and ulcer/amputation stump wound healing. Early and late results took into account rest pain, healing of ulcers/amputation stump with or without plastic coverage, claudication distance, resumption of previous occupation and domestic ambulation. The mean follow up of patients was 63 months. Immediate results were promising except two amputations. Early result were excellent to good in 56 and late results were excellent to good in 48 patients. Deterioration had significant correlation with smoking. Ilizarov's method is an excellent and cheap procedure in treatment of Buerger's disease.
在血栓闭塞性脉管炎中,保守治疗存在疑问。动脉重建手术不可行,交感神经切除术作用有限。疾病进展必然导致截肢。伊里扎洛夫方法可增加缺血肢体的血管生成。对60例患者采用伊里扎洛夫技术进行了回顾性分析。即时结果考虑了静息痛、皮肤颜色、静脉回流、温度、脉搏血氧仪测量的氧饱和度以及溃疡/截肢残端伤口愈合情况。早期和晚期结果考虑了静息痛、溃疡/截肢残端的愈合情况(有无整形覆盖)、跛行距离、恢复先前职业和家庭活动能力。患者的平均随访时间为63个月。除两例截肢外,即时结果很有前景。56例患者的早期结果为优至良,48例患者的晚期结果为优至良。病情恶化与吸烟有显著相关性。伊里扎洛夫方法是治疗血栓闭塞性脉管炎的一种出色且廉价的方法。