供体血管移植在下肢大动脉手术中的应用体会

Chur N. N., Skoda M. V., Neverov P. S., Kondratenko G. G., Kernozhitsky Y. I., Mikhailova N. M.
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摘要

今天,在糖尿病和动脉粥样硬化患者的下肢动脉手术中,自体静脉是黄金标准。它不需要任何选择、保存或其他必要的制备方法。然而,在某些情况下,由于其参数特性(长度、直径)、制备时间的损失以及它们的缺失,其使用受到限制。对于这类患者,选择的方法是使用同种异体血管移植。本文介绍25例死后供体血管移植治疗24例下肢严重缺血血运重建术的经验。所有患者分为2组:神经缺血性糖尿病足综合征组13例,下肢血管(动脉)闭塞性动脉粥样硬化组11例。阳性结果20例(83.3%)。在供体(1动脉,3静脉)血管重建术后的近期和长期内,4例(16.7%)患者行高位截肢,均为糖尿病患者。
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EXPERIENCE OF USE OF DONOR VASCULAR GRAFTS IN SURGERY OF THE MAIN ARTERIES OF THE LOWER LIMB
Today, in surgery of the arteries of the lower extremities in diabetes mellitus and atherosclerosis, the autovein is the gold standard. It does not require any selection, conservation, or other preparation methods necessary for its application. However, its use in some cases is limited due to their parametric characteristics (length, diameter), loss of time for their preparation, and their absence. For these categories of patients, the method of choice is the use of vascular allografts. The article presents the experience of 25 cases of post-mortem donor vascular grafts in 24 patients with lower limb revascularization with critical ischemia. All patients were divided into 2 groups: 13 patients were included in the first group with neuroischemic form of diabetic foot syndrome, and 11 patients were included in the second group with obliterating atherosclerosis of vessels (arteries) of the lower extremities. Positive results were noted in 20 patients (83.3%). In the immediate and long-term periods after revascularization with a donor graft (1 - artery, 3 - vein), high amputations were performed in 4 (16.7%) cases, all patients with diabetes mellitus.
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