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八旬老人腹主动脉-髂动脉闭塞性疾病的解剖外旁路手术

Extra-anatomic bypass for aorto-iliac occlusive disease in octogenarians.

作者信息

Sakakibara Y, Shigeta O, Hiramatsu Y, Jikuya T, Ijima H, Mitsui T, Hori M

机构信息

Department of Surgery, University of Tsukuba, Japan.

出版信息

Surg Today. 1993;23(2):120-4. doi: 10.1007/BF00311228.

Abstract

Fifteen patients over 80 years of age with aorto-iliac occlusive disease (AIOD) underwent surgical revascularization of an ischemic lower extremity by extra-anatomic bypasses. The mean age at operation was 81.7 years, ranging from 80 to 86 years. Surgical revascularization of the ischemic lower limbs could safely be performed with an extra-anatomic bypass in these patients without any major complications. The mean follow-up period was 32.7 months. Eight patients died during the follow-up, only one of them died from myo-nephropathic metabolic syndrome related to acute graft occlusion. As a long-term result, the cumulative survival after 37 months was only 23.9%, while the actual graft patency rate was 43.8% after 60 months in this series. The survival period with an improved quality of life after surgical intervention reached a level of approximately 40% of that for the general population. There should be no hesitation over whether to carry out surgical intervention for AIOD in patients over 80 years of age, because a reasonable extension of life can be obtained by an extra-anatomic bypass.

摘要

15名80岁以上患有主-髂动脉闭塞性疾病(AIOD)的患者通过解剖外旁路手术对缺血性下肢进行了血管重建。手术时的平均年龄为81.7岁,范围在80至86岁之间。在这些患者中,通过解剖外旁路手术可以安全地对缺血性下肢进行血管重建,且无任何重大并发症。平均随访期为32.7个月。8名患者在随访期间死亡,其中只有1例死于与急性移植物闭塞相关的肌肾代谢综合征。作为长期结果,本系列中37个月后的累积生存率仅为23.9%,而60个月后的实际移植物通畅率为43.8%。手术干预后生活质量改善的生存期达到了普通人群的约40%。对于80岁以上的AIOD患者,在是否进行手术干预上不应有任何犹豫,因为通过解剖外旁路手术可以合理延长寿命。

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