目的 對我院診治的腘動脈瘤病例進(jìn)行總結(jié)。方法 查閱我院1975~2004年11例腘動脈瘤患者病歷,對其資料進(jìn)行分析。結(jié)果 本組患者11例、患肢11條,常見的臨床表現(xiàn)依次為腘窩搏動性腫塊、跛行、伸膝困難、腫塊疼痛等,動脈瘤破裂3例(27.3%)。接受的特殊檢查有動脈造影、彩色多普勒。10例行手術(shù)治療,手術(shù)方式包括: 動脈瘤內(nèi)縫合修補(bǔ)術(shù)4例; 動脈瘤切除、血管移植術(shù)6例。病理結(jié)果: 假性動脈瘤3例、梅毒性動脈瘤3例、動脈粥樣硬化性動脈瘤4例。1例動脈瘤內(nèi)縫合修補(bǔ)術(shù)后出現(xiàn)患側(cè)小腿干性壞疽而行患側(cè)大腿下1/3截肢術(shù)。1例全身情況太差而未接受手術(shù)者死于心功能衰竭、晚期梅毒。術(shù)后隨訪1.5~30年,另外3例接受動脈瘤內(nèi)縫合修補(bǔ)術(shù)患者中1例有間歇性跛行; 1例患肢足背動脈能捫及搏動,無肢體缺血表現(xiàn); 1例失訪。6例接受動脈瘤切除、血管移植術(shù)患者中,1例失訪(Dacron人造血管移植); 1例有間歇性跛行; 4例患肢足背動脈能捫及搏動,無肢體缺血表現(xiàn)。結(jié)論 推廣彩色多普勒在人群篩查中的應(yīng)用可能有助于腘動脈瘤的檢出。有癥狀的腘動脈瘤及直徑大于3 cm的無癥狀腘動脈瘤應(yīng)接受手術(shù),直徑小于或等于3 cm的無癥狀腘動脈瘤可定期隨訪觀察。
引用本文: 馬玉奎,趙紀(jì)春,汪靜,金立人. 11例腘動脈瘤的診斷與治療. 中國普外基礎(chǔ)與臨床雜志, 2006, 13(6): 656-658. doi: 復(fù)制
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- 1. Martelli E, Ippoliti A, Ventoruzzo G, et al. Popliteal artery aneurysms. Factors associated with thromboembolism and graft failure [J]. Int Angiol, 2004; 23(1)∶54.
- 2. Vermilion BD, Kimmins SA, Pace WG, et al. A review of one hundred forty-seven popliteal aneurysms with long-term follow-up [J]. Surgery, 1981; 90(6)∶1009.
- 3. 王正周. 大隱靜脈移植治療腘動脈瘤一例 [J]. 中國修復(fù)重建外科雜志, 1998; 12(6)∶349.
- 4. 謝小平, 曾 強(qiáng). 腘動脈瘤血栓形成致小腿壞死1例 [J]. 四川醫(yī)學(xué), 2005; 26(1)∶24.
- 5. 郭大勇. 巨大腘動脈瘤切除1例報(bào)告 [J]. 華北煤炭醫(yī)學(xué)院學(xué)報(bào), 2001; 3(1)∶61.
- 6. 李 軍, 黃流清. 腘動脈瘤壓迫致脛神經(jīng)損害1例報(bào)告 [J]. 臨床神經(jīng)病學(xué)雜志, 2005; 18(2)∶145.
- 7. Dawson I, Sie RB, van Bockel JH. Atherosclerotic popliteal aneurysm [J]. Br J Surg, 1997; 84(3)∶293.
- 8. Galland RB, Magee TR. Management of popliteal aneurysm [J]. Br J Surg, 2002; 89(11)∶1382.
- 9. Davidovic LB, Lotina SI, Kostic DM, et al. Popliteal artery aneurysms [J]. World J Surg, 1998; 22(8)∶812.
- 10. Carpenter JP, Barker CF, Roberts B, et al. Popliteal artery aneurysms: current management and outcome [J]. J Vasc Surg, 1994; 19(1)∶65.
- 11. Ascher E, Markevich N, Schutzer RW, et al. Small popliteal artery aneurysms: are they clinically significant? [J].J Vasc Surg, 2003; 37(4)∶755.
- 12. Mahmood A, Salaman R, Sintler M, et al. Surgery of popliteal artery aneurysms: a 12-year experience [J]. J Vasc Surg, 2003; 37(3)∶586.
- 13. Robert B. Rutherford Eds. Rutherford vascular surgery [M]. 1st ed. Beijing: People’s Medical Publishing House, 2002∶1345-1356.