Esato K, Zempo N, O-hara M, Fujioka K, Kuga T
First Department of Surgery, Yamaguchi University School of Medicine, Ube, Japan.
Cardiovasc Surg. 1993 Jun;1(3):228-31.
The surgical results of primary peripheral arterial reconstruction for arteriosclerosis obliterans during a 16-year period were examined as a function of age. Data in group 1 were of 121 procedures performed on 95 patients aged > or = 70 years and those in group 2 of 215 procedures performed on 148 patients aged < or = 69 years. There was no significant difference between the operative mortality rate of 4% (four of 95) in group 1 and 3.4% (five of 148) in group 2. The long-term mortality rate was 33% (31 of 95) in group 1, significantly higher (P < 0.05) than 18.9% (28 of 148) in group 2. The most common cause of death in both groups was cardiac failure. Cumulative 5-year survival rates in groups 1 and 2 were 56.3 and 78.3% respectively (P < 0.0001). The cumulative primary 5-year patency rates of suprainguinal bypass grafts in the two groups were 94.2 and 90.4%, respectively, while those of infrainguinal reconstruction were 67.7 and 55.0% respectively. The 5-year cumulative limb salvage rate was 93.1% in group 1 and 92.7% in group 2. None of these differences was significant. The results support an active approach to surgery in elderly patients with peripheral arterial obstruction caused by arteriosclerosis obliterans.
在16年期间，对因动脉硬化闭塞症进行的原发性外周动脉重建手术结果按年龄进行了研究。第1组数据来自对95例年龄≥70岁患者实施的121例手术，第2组数据来自对148例年龄≤69岁患者实施的215例手术。第1组的手术死亡率为4%（95例中的4例），第2组为3.4%（148例中的5例），两者无显著差异。第1组的长期死亡率为33%（95例中的31例），显著高于第2组的18.9%（148例中的28例）（P<0.05）。两组最常见的死亡原因均为心力衰竭。第1组和第2组的5年累积生存率分别为56.3%和78.3%（P<0.0001）。两组中腹股沟上旁路移植的5年累积原发性通畅率分别为94.2%和90.4%，而腹股沟下重建的通畅率分别为67.7%和55.0%。第1组和第2组的5年累积肢体挽救率分别为93.1%和92.7%。这些差异均无统计学意义。这些结果支持对因动脉硬化闭塞症导致外周动脉阻塞的老年患者采取积极的手术治疗方法。
