中国实用外科杂志2024，Vol.44Issue(12)：1347-1350,4.DOI:10.19538/j.cjps.issn1005-2208.2024.12.05
感染性动脉疾病移植物的合理选择
Rational selection of grafts for infectious arterial diseases
摘要
Abstract
Infectious arterial diseases are rare but carry high morbidity and mortality rates.Treatment focuses on eradicating infectious focus and restoring blood flow,with the choice of graft being critical for surgical success and patient prognosis.According to the detailed situation,revascularization strategies can be divided into in situ reconstruction and extra-anatomic bypass,each with specific advantages and disadvantages.The decision must be individualized based on the extent of infection,microbial virulence,and the patient's overall condition.Graft options include several types:standard synthetic grafts and stent-grafts can be used for localized infections or when no better alternatives are available;rifampin-soaked grafts are effective against Staphylococcus aureus and other Gram-positive bacteria,though less effective against methicillin-resistant Staphylococcus aureus(MRSA);silver-coated grafts offer broad-spectrum antimicrobial activity,but their efficacy against highly virulent strains remains controversial.Autologous veins,particularly the great saphenous vein,are the first choice for non-aortic infections,while for aortoiliac infections,the neo-aortoiliac system(NAIS)technique may be considered.Cryopreserved allografts are suitable for severe infections but are difficult to meet emergency needs due to reservation requirements.Xenografts,such as bovine pericardium patches,provide a flexible and convenient option,especially when other materials are unavailable.Human acellular vessels(HAVs)have shown promising anti-infective potential in clinical research but are still in experimental stages.The treatment of infectious arterial diseases requires a combination of antimicrobial therapy and surgical intervention.Complete debridement of infectious focus and appropriate graft selection are crucial for reducing the risk of reinfection.However,there are currently no definitive guidelines for graft selection,and decisions must be tailored to the patient's overall condition,extent of infection,and antibiotic susceptibility,ensuring an individualized treatment approach.关键词
感染性动脉疾病/原位血运重建/血管移植物/人工血管/自体静脉/同种异体移植物/异种移植物Key words
infectious arterial diseases/in situ revascularization/vascular grafts/synthetic grafts/autologous veins/allografts/xenografts分类
医药卫生引用本文复制引用
符伟国,岳嘉宁,王琪..感染性动脉疾病移植物的合理选择[J].中国实用外科杂志,2024,44(12):1347-1350,4.基金项目
国家重点研发计划项目(No.2023YFC2412405) （No.2023YFC2412405）
