Urayama H, Misaki T, Watanabe Y, Bunko H
First Department of Surgery, Kanazawa University School of Medicine, Japan.
J Cardiovasc Surg (Torino). 1993 Oct;34(5):389-93.
One hundred thirty-one limbs of 109 patients who underwent femoropopliteal artery by-pass were studied for postoperative saphenous neuralgia and limb edema. The following factors were analyzed: age, sex, underlying disease (arteriosclerosis obliterans or Buerger's disease), grade of symptoms (Fontaine's classification), presence of diabetes mellitus, the site of distal anastomosis (above or below the knee), vascular graft material (reversed saphenous vein, expanded polytetrafluoroethylene or composite), presence of postoperative hematoma, and levels of serum creatinine and albumin 3 weeks after surgery. To examine limb edema, radioisotope (RI) venography and RI lymphography were performed. Saphenous neuralgia occurred in 22 limbs (16.8%) and limb edema in 27 limbs (20.6%). None of the factors examined was found to be significantly associated with saphenous neuralgia. The risk of developing limb edema was higher in diabetic patients and in patients in whom the distal anastomosis was performed below the knee. Although no case of limb edema was associated with signs of obstruction on RI venogram, 80% of the cases showed lymphatic obstruction on RI lymphograms.
对109例行股腘动脉搭桥术患者的131条肢体进行了术后隐神经痛和肢体水肿研究。分析了以下因素：年龄、性别、基础疾病（闭塞性动脉硬化或血栓闭塞性脉管炎）、症状分级（Fontaine分级）、糖尿病的存在、远端吻合部位（膝上或膝下）、血管移植材料（大隐静脉反转、膨体聚四氟乙烯或复合材料）、术后血肿的存在以及术后3周的血清肌酐和白蛋白水平。为检查肢体水肿，进行了放射性核素（RI）静脉造影和RI淋巴造影。22条肢体（16.8%）出现隐神经痛，27条肢体（20.6%）出现肢体水肿。未发现所检查的因素与隐神经痛有显著相关性。糖尿病患者和远端吻合在膝下的患者发生肢体水肿的风险更高。虽然没有一例肢体水肿与RI静脉造影的阻塞征象相关，但80%的病例在RI淋巴造影中显示淋巴管阻塞。
