Ukhanov A P, Shcheglov V I
Khirurgiia (Mosk). 1994 Jun(6):18-20.
At the department of vascular surgery of the Novgorod Regional Hospital 455 reconstructive operations for atherosclerotic occlusions in the aorto-ileo-femoral segment were performed in 1984-1991. Thrombotic reocclusion occurred in 58 patients (12.7%) for which a second operation had to be conducted, early thromboses of the reconstructed segment were encountered in 16 patients (3.5%) and late thromboses in 42 (9.2%). The work analyses the causes of early and late reocclusions, substantiates the surgical tactics, and discusses the technical characteristics of the operation. Thrombectomy with reconstruction of the distal anastomosis and the draining paths was the main method of treatment. It was conducted in 12 patients with early and in 21 patients with late reocclusions. The results of surgical treatment are shown. It is concluded that repeated reconstructive operations are a sufficiently effective measure for preserving the function of the earlier operated on limb; they made it possible to produce positive immediate results in 81.0% and late-term results in 64.3% of patients.
1984年至1991年期间,诺夫哥罗德地区医院血管外科对455例主-髂-股段动脉粥样硬化闭塞症患者实施了重建手术。58例患者(12.7%)发生血栓再闭塞,需进行二次手术;16例患者(3.5%)出现重建段早期血栓形成,42例患者(9.2%)出现晚期血栓形成。本文分析了早期和晚期再闭塞的原因,阐述了手术策略,并讨论了手术的技术特点。血栓切除术联合远端吻合口及引流路径重建是主要治疗方法。12例早期再闭塞患者和21例晚期再闭塞患者接受了该手术。文中展示了手术治疗结果。得出的结论是,重复重建手术是保留早期手术肢体功能的一种足够有效的措施;该措施使81.0%的患者获得了积极的即刻效果,64.3%的患者获得了远期效果。