摘要目的 探讨腰椎疾病同时合并下肢动脉闭塞症所致间歇性跛行的诊治原则.方法 对18例患有腰椎疾病同时合并下肢动脉闭塞症的患者,利用MRI和MRA检查判定所致患者疾病的主要病因,采取针对病因的适宜治疗.结果 本组病例全部获得随访,随访时间7～24(16.0±4.7)个月.按改良MacNab标准评定临床疗效,优7例,良8例,可3例,优良率为83.3%(15/18).全部病例间歇性跛行明显改善,行走距离超过1000m,改善率100%.术后踝肱指数(ABI)0.90±0.54,较术前(0.58±0.36)明显增加,差异有统计学意义(P<0.01).全部病例没有因循环障碍而截肢.结论 对于腰椎疾病同时合并下肢动脉闭塞症患者的诊治,要认真采集病史和仔细查体,结合影像学检查,可以准确判定责任病灶,有的放矢给予相应的治疗,可以获得良好的疗效.

abstractsObjective To explore the principle of diagnosis and treatment of intermittent claudication caused by lumbar spine disease combined with lower extremity arteriosclerosis obliterans. Method Eighteen cases of patients with intermittent claudication caused by lumbar spine disease combined with lower extremity arteriosclerosis obliterans, using MRI and MRA, to determine the main reason due to of disease, to take the treatment for the cause. Results The patients were followed up for 7 to 24 months, average (16.0 ± 4.7) months. Assessed according to the modified MacNab criteria of clinical efficacy, excellent in 7 cases, good in 8 cases, general in 3 cases,satisfactory rate was 83.3%(15/18). Intermittent claudication were improved with all patients, walking distance of more than 1000 meters, relief rate was 100%. Postoperative ankle brachial score(0.90±0.54 ) was obviously increased compared with preoperative average(0.58±0.36), there was significant statistical difference(P<0.01). All cases were not amputee due to circulation disturbance. Conclusion The diagnosis and treatment of intermittent claudication caused by lumbar spine disease combined lower extremity arteriosclerosis obliterans,it is necessary to collect a history of serious and careful investigation,combined with imaging, can accurately determine the responsibility of lesions, target to give the appropriate treatment, can get a good effect