Lacombe M
Hôpital Beaujon, Clichy.
Chirurgie. 1997;122(10):516-20.
Thirty eight patients on chronic hemodialysis were operated on for treatment of complicated aortoiliac atherosclerosis: 31 had aneurysms and 7 had stenotic or obstructive lesions. The 35 male and three female patients ranged in age from 39 to 78 years (mean: 55.3). The duration of hemodialysis treatment before the operation ranged from one month to 22 years but 80% of the patients were operated on during the first five years following the beginning of maintenance hemodialysis. The surgical repairs consisted of long aorta to femoral artery prosthesis in obstructive lesions and of short prostheses in cases of aneurysms so as not to make more difficult subsequent renal transplantation. All patients were operated on from 6 to 18 hours after a dialysis. Hemodialysis was resumed on the day of surgery in few patients or later according to the level of kalemia. Postoperative mortality rate was 10.5% and morbidity 13.5%. Only seven patients underwent secondary renal transplantation. The long-term survival rate was 43% at five years and 11% at ten years. Late deaths were due to coronary artery disease or to worsening of arterial lesions in the lower limbs.
38例慢性血液透析患者接受了复杂性主髂动脉粥样硬化的手术治疗：31例患有动脉瘤，7例患有狭窄或阻塞性病变。35例男性患者和3例女性患者年龄在39岁至78岁之间（平均：55.3岁）。手术前血液透析治疗时间从1个月至22年不等，但80%的患者是在维持性血液透析开始后的头五年内接受手术的。手术修复包括在阻塞性病变中使用从主动脉到股动脉的长人工血管，在动脉瘤病例中使用短人工血管，以免给后续的肾移植带来更大困难。所有患者均在透析后6至18小时接受手术。少数患者在手术当天恢复血液透析，其他患者则根据血钾水平在术后晚些时候恢复。术后死亡率为10.5%，发病率为13.5%。只有7例患者接受了二次肾移植。五年时长期生存率为43%，十年时为11%。晚期死亡原因是冠状动脉疾病或下肢动脉病变恶化。
