Comparison of the long-term results between surgical and conservative treatment in patients with intermittent claudication.
Comparison of the long-term results between surgical and conservative treatment in patients with intermittent claudication.
复制标题
间歇性跛行患者手术与保守治疗的长期结果比较。
作者：
E. Mori;K. Komori;M. Kume;T. Yamaoka;T. Shoji;T. Furuyama;H. Inoguchi
背景
间歇性跛行患者的可选治疗策略仍然存在争议。在这项研究中，我们调查了手术和保守治疗对改善间歇性跛行患者生活质量的影响。
方法
我们对1984年1月至1999年12月间收治的427例腿部间歇性跛行患者进行了分析。手术治疗259例(362条小腿)，保守治疗168例。
结果
在腹股沟上和腹股沟下(膝盖以上)，手术组的改善率明显好于保守治疗组，但在腹股沟下(膝盖以下)，两组之间没有显著差异。腹股沟上、下区动脉重建的3年和5年通畅率令人满意，而腹股沟下区动脉重建的通畅率较差，即使采用自体静脉移植。
结论
因此，对于远端吻合口在膝盖以上的患者，推荐积极的手术治疗，因为手术重建有很大的好处。然而，对于远端吻合口位于膝盖以下的患者，保守治疗可能与手术同样有效。
BACKGROUND
The optional therapeutic strategy for patients with intermittent claudication remains controversial. In this study, we investigated the influence of surgical and conservative therapies on improving the quality of life in patients with intermittent claudication.
METHODS
We analyzed 427 patients who were admitted to our hospital with intermittent claudication in their legs during a 15-year period from January 1984 to December 1999. We separated them into 2 groups; 259 patients (362 legs) were treated surgically and 168 patients were treated conservatively.
RESULTS
At the suprainguinal and infrainguinal (above knee) region, the surgery group showed significantly better rate of improvement than did the conservative group, but in the infrainguinal (below knee) region, there was no significant difference between the 2 groups. The 3-year and 5-year patency rates for the arterial reconstruction of the suprainguinal and infrainguinal region was satisfactory, but that of the infrainguinal region was not very good even if an auto vein graft was used.
CONCLUSIONS
Aggressive surgical treatment is therefore recommended in patients whose distal anastomotic region is above the knee, because there are great benefits from surgical reconstruction. However, in patients whose distal anastomotic region is below the knee, conservative treatment might be just as effective as surgery.
影响因子：
158.5
作者：
CRIQUI, MH;LANGER, RD;BROWNER, D
通讯作者：
BROWNER, D