Kretschmer G, Wenzl E, Huk I, Polterauer P, Ehringer H, Minar E, Schemper M
I. Chirurgische Universitätsklinik, Wien.
Wien Klin Wochenschr. 1987 Sep 11;99(17):591-5.
Eighty-eight patients underwent a classical reversed saphenous vein graft for femoro-popliteal occlusive disease and were enrolled in a controlled clinical trial. During the second postoperative week the patients were allocated randomly into one of two groups: group I consisted of 42 patients who received dicumarol and group II (46 patients) served as a control group without any anticoagulant treatment. The mean follow-up time was 24 months. After 12 months the cumulative patency rate was 82%, after 18 months 76% and after 24 months 76%; for patients receiving dicumarol treatment the respective figures were 92%, 86% and 86% and for those with no treatment 70%, 67% and 67%, the difference being significant. When the bypass operation was performed for limb salvage (clinical stages III and IV) the overall results were worse (12 months: 72%, 18 months: 68%, 24 months: 68%) than in stages II, II-III (12 months: 90%, 18 months: 85%, 24 months: 85%). In limb salvage surgery the positive effects of anticoagulant treatment were significant (with treatment: 12 months 87%, 18 months 86%, 24 months 86%; without treatment: 12 months 58%, 18 months 54%, 24 months 54%).
88例患有股腘动脉闭塞性疾病的患者接受了经典的大隐静脉转流术,并被纳入一项对照临床试验。术后第二周,患者被随机分为两组:第一组由42例接受双香豆素治疗的患者组成,第二组(46例患者)作为未接受任何抗凝治疗的对照组。平均随访时间为24个月。12个月后累积通畅率为82%,18个月后为76%,24个月后为76%;接受双香豆素治疗的患者相应数字分别为92%、86%和86%,未接受治疗的患者分别为70%、67%和67%,差异具有显著性。当为挽救肢体(临床分期III和IV期)进行旁路手术时,总体结果比II期、II - III期(12个月:90%,18个月:85%,24个月:85%)更差(12个月:72%,18个月:68%,24个月:68%)。在挽救肢体手术中,抗凝治疗的积极效果显著(接受治疗:12个月87%,18个月86%,24个月86%;未接受治疗:12个月58%,18个月54%,24个月54%)。