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[达迪克移植物与明迪奇移植物在动脉搭桥术中的比较]

[A comparison with Dardik graft and Mindich graft on arterial bypass].

作者信息

Ohara M, Esato K, Nakano H, Nomura S, Noma N, Nishiyama T, Mohri H

出版信息

Nihon Geka Gakkai Zasshi. 1984 Jul;85(7):734-8.

PMID:6493196
Abstract

Arterial reconstruction using human umbilical cord vein graft as a vascular prosthesis was carried out in 24 patients, 26 legs, with arteriosclerosis obliterans. Dardik grafts were used in 13 legs and Mindich grafts in 13 legs. Twenty-six operations were divided into two groups; one with the proximal anastomosis above the femoral artery (proximal group) and the other with the proximal anastomosis below the femoral artery (distal group). Postoperative evaluation of all patients was performed at intervals of one to twenty-two months. To make the determination of graft patency, at least, it was required that the graft pulse was palpable. Cumulative patency rates were 54% and 69% in the Mindich grafts and Darkik grafts, respectively. In the proximal group, patency rates were 60% and 50% in Mindich grafts and Dardik grafts, respectively. While in the distal group, patency rates were 37.5% and 78% in Mindich grafts and Dardik grafts, respectively. The causes of the graft obstruction were as follows: 1) graft infection in 4 (2 with Mindich and 2 with Dardik grafts) 2) pseudointimal hyperplasia of the distal anastomosis in 4 with Mindich graft, 3) progression of atherosclerosis in one case with Dardik graft, and 4) substandard Dardik graft in one. It was concluded that Dardik graft should be used as first choice when compared with Mindich graft and these grafts should not be used easily, since these grafts were apt to be infected.

摘要

对24例(26条腿)患有动脉硬化闭塞症的患者使用人脐静脉移植物作为血管假体进行动脉重建。13条腿使用达迪克移植物,13条腿使用明迪奇移植物。26例手术分为两组;一组近端吻合在股动脉上方(近端组),另一组近端吻合在股动脉下方(远端组)。所有患者术后每隔1至22个月进行评估。为确定移植物通畅情况,至少要求能摸到移植物搏动。明迪奇移植物和达迪克移植物的累积通畅率分别为54%和69%。在近端组,明迪奇移植物和达迪克移植物的通畅率分别为60%和50%。而在远端组,明迪奇移植物和达迪克移植物的通畅率分别为37.5%和78%。移植物阻塞的原因如下:1)4例移植物感染(2例为明迪奇移植物,2例为达迪克移植物);2)4例明迪奇移植物远端吻合口假内膜增生;3)1例达迪克移植物出现动脉粥样硬化进展;4)1例达迪克移植物不合标准。得出的结论是,与明迪奇移植物相比,应首选达迪克移植物,且不应轻易使用这些移植物,因为这些移植物容易感染。

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