Kết quả điều trị ngoại khoa thiếu máu mạn tính chi dưới do xơ vữa động mạch tại Bệnh viện Hữu nghị Việt Đức giai đoạn 2020

Kết quả điều trị ngoại khoa thiếu máu mạn tính chi dưới do xơ vữa động mạch tại Bệnh viện Hữu nghị Việt Đức giai đoạn 2020 - 2022

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Ngọc Thắng Dương, Hữu Ước Nguyễn, Quốc Hưng Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại: 617.58 *Lower extremities

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2023

Mô tả vật lý: 45296

Bộ sưu tập: Metadata

ID: 502543

Thêm vào giỏ

Đánh giá kết quả sớm của các kỹ thuật tái tưới máu động mạch bằng ngoại khoa, điều trị thiếu máu mạn tính chi dưới do xơ vữa động mạch, tại bệnh viện Hữu nghị Việt Đức trong giai đoạn 2020 - 2022. Phương pháp nghiên cứu: Mô tả hồi cứu, cắt ngang các bệnh nhân thiếu máu mạn tính chi dưới do xơ vữa động mạch về các đặc điểm trước mổ, kỹ thuật ngoại khoa tái tưới máu động mạch và kết quả sớm sau mổ, tại Bệnh viện Hữu nghị Việt Đức từ tháng 1 năm 2020 đến tháng 12 năm 2022. Kết quả: Có 132 bệnh nhân với tuổi trung bình 69,6 ± 10,7 tuổi, nam giới chiếm 87,9%. Tăng huyết áp, hút thuốc lá/thuốc lào là hai yếu tố nguy cơ thường gặp nhất. Theo phân loại Fontaine: 14 bệnh nhân giai đoạn IIb, 37 bệnh nhân giai đoạn III, 81 bệnh nhân giai đoạn IV. Có 91,7% được tái thông động mạch bằng kỹ thuật ngoại khoa kinh điển, và 8,3% bệnh nhân được điều trị theo phương pháp hybrid (phẫu thuật kết hợp can thiệp nội mạch đồng thì). Biến chứng tắc cầu nối chiếm 8,3%. Tử vong trong 30 ngày sau mổ có 5,3%. Tỷ lệ cầu nối động mạch còn thông sau mổ 6 tháng là 90,8%. Kết luận: Bệnh lý thiếu máu mạn tính chi dưới do xơ vữa động mạch gặp ngày càng nhiều về số lượng và phức tạp về tổn thương, song nhờ sự hỗ trợ của chẩn đoán và can thiệp nội mạch phối hợp, nên kết quả điều trị tái tưới máu động mạch vẫn rất khả quan, trong đó hybrid là hướng điều trị mới mang đến nhiều lợi ích và lựa chọn cho thầy thuốc và bệnh nhânTo evaluate early results of surgical revascularization techniques for treatment of chronic lower extremity ischemia due to atherosclerosis, at Viet Duc University Hospital in the period of 2020 - 2022. Method: Retrospective, cross-sectional description of patients with chronic lower extremity ischemia due to atherosclerosis in terms of preoperative characteristics, surgical technique of arterial reperfusion and early postoperative results, from January 2020 to December 2022. Results: There were 132 patients with average age of 69.6 ± 10.7 years, male accounted for 87.9%. High blood pressure and smoking/pipe tobacco are the two most common risk factors. According to Fontaine classification: 14 patients with stage IIb, 37 patients with stage III, 81 patients with stage IV. There were 91.7% revascularization by classic surgical techniques, and 8.3% of patients were treated by hybrid method (surgery combined with concurrent endovascular intervention). Complications of bypass occlusion accounted for 8.3%. Mortality within 30 days after surgery was 5.3%. The rate of arterial bypass remaining open 6 months after surgery was 90.8%. Conclusion: Chronic ischemic disease of lower extremities due to atherosclerosis is increasingly encountered in number and complexity of lesions, but thanks to the support of diagnosis and combined endovascular intervention, the results of treatment arterial reperfusion therapy is still very promising, in which hybrid is a new treatment direction that brings many benefits and options for doctors and patients.

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