Ohta Takashi, Ishibashi Hiroyuki, Sugimoto Ikuo, Iwata Hirohide, Kawanishi Jun, Yamada Tetsuya, Tadakoshi Masao, Hida Noriyuki
Department of Surgery, Division of Vascular Surgery, Aichi Medical University, Aichi, Japan.
Ann Vasc Dis. 2008;1(2):85-90. doi: 10.3400/avd.AVDct00208. Epub 2008 Oct 24.
The clinical and social characteristics of 118 patients with Buerger's disease (thromboangiitis obliterans: TAO) were surveyed. The prognosis for many patients is relatively favorable. Arterial reconstruction plays a role in shortening the healing times of ischemic ulcers despite its poor long-term results. Of 118 patients, 13 underwent major lower limb amputation (11%), 33 underwent foot or toe amputation (28%), one underwent hand amputation (1%), and 12 underwent finger amputations (10%) after the onset of the disease. The progression of symptoms was surely influenced by smoking, but this was not the only deleterious factor as there were patients with stable TAO which was unaffected by their continued smoking. In 66 patients, the new occurrence of ulceration and gangrene was not observed over the age of 60. Ten of 13 patients (77%) who underwent major lower limb amputation lost their jobs, but only 7 of 105 patients without major amputation lost their jobs (7%). In all patients, the progression of symptoms was self-limited and recurrent ulcers occurred less frequently with ageing. To avoid factors that markedly influence the quality of life, early treatment and strict instructions prohibiting smoking should be conducted.
对118例血栓闭塞性脉管炎（TAO）患者的临床和社会特征进行了调查。许多患者的预后相对良好。尽管动脉重建的长期效果不佳，但它在缩短缺血性溃疡的愈合时间方面发挥着作用。在118例患者中，发病后有13例接受了下肢大截肢（11%），33例接受了足部或趾部截肢（28%），1例接受了手部截肢（1%），12例接受了手指截肢（10%）。症状的进展肯定受到吸烟的影响，但这不是唯一的有害因素，因为有一些血栓闭塞性脉管炎病情稳定的患者，其病情并未因持续吸烟而受到影响。在66例患者中，60岁以上未观察到新的溃疡和坏疽发生。接受下肢大截肢的13例患者中有10例（77%）失去了工作，但未接受大截肢的105例患者中只有7例（7%）失去了工作。在所有患者中，症状的进展是自限性的，随着年龄的增长，复发性溃疡的发生频率降低。为避免明显影响生活质量的因素，应进行早期治疗并严格指示禁止吸烟。
