腘动脉陷迫综合征23例

摘要

Objective: To summarize experience of iconography examination and treatment of surgery in 23 cases's (26 limps) popliteal artery entrapment syndrome (PAES). Methods: From 2003 to 2012,23 patients (25 limps) were diagnosed as PAES underwent surgery The 23 patients with a mean age of (31.17 ±14.42) years,19 patients were male,4 patient was female.Three patient was found to have bilateral involvement, and one patient with deep vein thrombosis in two lower limps.Intermittent claudication was the most frequent presenting symptom. Iconography examination include doppler ultrasonography,CTA and MRA before to do surgery in these cases.And ankle brachial index (ABI) will be contrast before and after opration.Tenolysis of malformed muscle round of popliteal artery in 21 limps,in addition,bypass in 9 limps with artery occlusion, endarterectomy and artery autoplasty in 8 limps with artery stenosis.Simple femoral-popleteal bypass with great saphe-nous veins in 5 limps. MtesuUs: The average time of follow up is (30.09 ± 17.92) months.Symptom of intermittent claudication was disappeared in 22 cases,and the ABI ascended from0.44 ± 0.09 before opration to 0.92 ±0.10 after opration,there was a significantly difference (P<0.01). 1 cases died because of pulmonary embolism one day after surgery. Conclusion: PAES is an important cause of limp claudication, iconography is an very important examination to diagnose . It will have a favourable prognosis with active surgery in early time.%目的:分析23例口动脉陷迫综合征(PAES)的临床资料,总结PAES影像学诊断与手术治疗的经验.方法:23例(26条下肢)PAES患者,男19例,女4例,年龄5～ 64岁,平均(31.2±14.4)岁.患者术前施行了超声多普勒,CTA或MR检查,并对25条患肢施行了相应的手术治疗,监测手术前后患肢踝肱指数(ABI)变化.20条患肢施行了口动脉周围异常组织松解术,其中9条因动脉闭塞同时施行了大隐静脉旁路移植术,7条患肢因动脉内膜增厚实行口动脉内膜切除加动脉成形术；5条肢体行自体大隐静脉移植术.结果:22例患者随访6月～6年,平均(30.09±17.92)个月,25条手术肢体间歇性跛行症状治愈,踝肱指数由术前的0.44±0.09上升至术后的0.92±0.10(P＜0.01).1例患者因肺动脉栓塞术后1d死亡.结论:PAES是慢性下肢动脉缺血的一个病因,影像学诊断是确诊本病的重要手段,早期积极外科干预预后较好.