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[间歇性跛行的预后]

[The prognosis of intermittent claudication].

作者信息

Ohta T, Kato R, Kazui H, Kondo M, Tsuchioka H, Shionoya S

机构信息

Second Department of Surgery, Aichi Medical University, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1989 Apr;90(4):615-21.

PMID:2761528
Abstract

The purpose of this study is to obtain the informations about the fate of the limbs and lives of claudicants due to arteriosclerosis obliterans. Two hundred and seven lower limbs of 165 patients suffering from intermittent claudication were observed for an average period of about six years. Eighty-seven limbs of 69 patients were managed nonsurgically (Group A). Ninety-eight percent of limbs in Group A remained unchanged or improved, and no limb was amputated. One hundred and twenty limbs of 96 patients had arterial reconstructions (Group B). Although 75 percent of limbs in Group B had benefits by successful operations, 26 percent of them experienced graft failures, and 2.7 percent of them were amputated. Five year graft patency rates in the limbs with supra- and infra-inguinal reconstructions were 82.1 percent and 65.7 percent, respectively. Operative mortality rate was 2.1 percent, and mortality rate due to late complications was 3.3 percent. The prognosis of intermittent claudication with regular follow-up was relatively good, therefore, it is important to recognize that arterial reconstruction is not the only way to treat limbs with mild intermittent claudication. About 30 percent of claudicants died within 5 years, and 60 percent of them died from cardiac or cerebrovascular disease. The results suggested that much attention should be paid to the lives as well as the limbs of claudicants.

摘要

本研究的目的是获取有关因动脉硬化闭塞症导致间歇性跛行患者肢体转归及生存情况的信息。对165例间歇性跛行患者的207条下肢进行了平均约6年的观察。69例患者的87条下肢采用非手术治疗(A组)。A组中98%的肢体保持不变或有所改善,无肢体被截肢。96例患者的120条下肢进行了动脉重建手术(B组)。尽管B组中75%的肢体通过成功手术获得了益处,但其中26%发生了移植物失败,2.7%的肢体被截肢。腹股沟上和腹股沟下重建肢体的5年移植物通畅率分别为82.1%和65.7%。手术死亡率为2.1%,晚期并发症导致的死亡率为3.3%。间歇性跛行患者经定期随访,预后相对较好,因此,必须认识到动脉重建并非治疗轻度间歇性跛行肢体的唯一方法。约30%的间歇性跛行患者在5年内死亡,其中60%死于心脏或脑血管疾病。结果表明,应高度关注间歇性跛行患者的肢体及生存情况。

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