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股腘动脉轴的静脉逆行旁路移植术(作者译)

[Reversed vein bypass for the femoro-popliteal axis (author's transl)].

作者信息

Mellière D, Bertin J

出版信息

Nouv Presse Med. 1980 Mar 1;9(10):681-5.

PMID:7375347
Abstract

One hundred and twenty nine saphenous femoro-popliteal or infra-popliteal bypass were realised in 125 patients, 55 for very short distance intermittent claudication, 32 for rest pain, 38 for distal gangrene. A one to seven years follow up allows to draw four conclusions: -- In spite of a 4% mortality and a decrease of permeability from 88% at one year to 58% at 5 years, one must consider that in most cases the limb was saved, pain disappeared and the patient was able to work again. -- In case of intermittent claudication, operative indication should be very limited to severe socio-professional disturbance. In contrast, one should not hesitate in case of limb threatening. -- If a thrombosis of the bypass occurs, the spontaneous prognosis is hazardous and the patient should immediately be sent back to the surgical team that first operated. -- Since preventive reoperations have better prognosis than curative reoperations, the authors emphazise the interest of a systematic research of late stenosis or aneurism at the bypass level or up or down in order to correct the trouble prior to acute ischemic complication.

摘要

125例患者共进行了129次隐股-腘动脉或腘以下动脉搭桥手术,其中55例用于治疗极短距离间歇性跛行,32例用于治疗静息痛,38例用于治疗远端坏疽。经过1至7年的随访,可以得出四点结论:——尽管死亡率为4%,血管通畅率从术后1年的88%降至5年时的58%,但必须认识到,在大多数情况下,肢体得以保全,疼痛消失,患者能够重新工作。——对于间歇性跛行,手术指征应严格限于严重影响社会职业活动的情况。相反,对于有肢体威胁的情况则不应犹豫。——如果搭桥血管发生血栓形成,其自然转归凶险,患者应立即返回首次手术的外科团队。——由于预防性再次手术的预后优于补救性再次手术,作者强调有必要对搭桥血管及其上下方进行系统检查,以发现晚期狭窄或动脉瘤,从而在急性缺血并发症发生之前纠正问题。

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