经皮腔内支架成形术治疗下肢动脉硬化闭塞症对比研究
|
摘要
目的分析经皮腔内支架成形术治疗下肢动脉硬化闭塞症的影响。方法选取2015年8月至2017年5月,青岛市中心(肿瘤)医院拟接受手术治疗的116例下肢动脉硬化闭塞患者,随机分为观察组与对照组,每组58例。对照组患者在常规治疗基础上采取球囊扩张术,观察组在常规治疗基础上采取经皮腔内支架成形术进行治疗。结果观察组总有效率96.55%(56/58),对照组总有效率82.76%(48/58),差异有统计学意义(χ~2=5.952,P=0.015)。观察组并发症发生率5.17%(3/58),对照组12.07%(7/58),差异有统计学意义(χ~2=1.936,P=0.013)。观察组治疗后6个月踝肱指数(ankle brachial index,ABI)指数0.99±0.12,对照组治疗后6个月ABI指数0.84±0.09,差异有统计学意义(t=6.034,P=0.014)。观察组治疗后6个月跛行距离(553.42±103.34)m,对照组治疗后6个月跛行距离(336.48±48.87)m,差异有统计学意义(t=5.133,P=0.023)。结论经皮腔内支架成形术可以有效应用于下肢动脉硬化闭塞症的治疗中,提高治疗效果,改善患者ABI指数及跛行距离。
Objective To analyze the effective observation of lower extremity atherosclerotic occlusive disease under the percutaneous transluminal angioplasty and stenting and influences on patients′ Ankle Brachial Index(ABI) and claudication distance. Methods 116 patients with lower extremity atherosclerotic occlusive disease who accepted operative treatment in the hospital from August 2015 to May 2017 were selected as the research objects and divided into the treatment and control groups at random, including 58 patients in each group. Results The total effective rate was 96.55% in the treatment group, while 82.76% in the control group.The treatment group was significantly better than the control group(χ~2=5.952,P=0.015).The incidence of complications in the treatment group was 5.17%, significantly lower than 12.06% in the control group(χ~2=1.936,P=0.013).The ABI index in the treatment group was 0.99±0.12 at 6 months after treatment, and 0.84±0.09 at 6 months after treatment in the control group.The lameness distance in the treatment group was(553.42±103.34) m at 6 months after treatment, while that in the control group was(336.48±48.87) m at 6 months after treatment.the ABI index(t=6.034,P=0.014) and claudication distance(t=5.133,P=0.023) after treatment in the treatment group were significantly higher than those in the control group. Conclusions Percutaneous transluminal angioplasty and stenting can be effectively applied in the treatment of lower extremity atherosclerotic occlusive disease.It not only is good for improving the clinical treatment effects, but also is good for improving the patients,ABI and claudication distance.
Objective To analyze the effective observation of lower extremity atherosclerotic occlusive disease under the percutaneous transluminal angioplasty and stenting and influences on patients′ Ankle Brachial Index(ABI) and claudication distance. Methods 116 patients with lower extremity atherosclerotic occlusive disease who accepted operative treatment in the hospital from August 2015 to May 2017 were selected as the research objects and divided into the treatment and control groups at random, including 58 patients in each group. Results The total effective rate was 96.55% in the treatment group, while 82.76% in the control group.The treatment group was significantly better than the control group(χ~2=5.952,P=0.015).The incidence of complications in the treatment group was 5.17%, significantly lower than 12.06% in the control group(χ~2=1.936,P=0.013).The ABI index in the treatment group was 0.99±0.12 at 6 months after treatment, and 0.84±0.09 at 6 months after treatment in the control group.The lameness distance in the treatment group was(553.42±103.34) m at 6 months after treatment, while that in the control group was(336.48±48.87) m at 6 months after treatment.the ABI index(t=6.034,P=0.014) and claudication distance(t=5.133,P=0.023) after treatment in the treatment group were significantly higher than those in the control group. Conclusions Percutaneous transluminal angioplasty and stenting can be effectively applied in the treatment of lower extremity atherosclerotic occlusive disease.It not only is good for improving the clinical treatment effects, but also is good for improving the patients,ABI and claudication distance.
引文
[1] 骆曦图,杨澄宇,刘正军.经皮腔内血管成形术联合血管内支架治疗下肢动脉硬化闭塞症疗效观察[J].现代中西医结合杂志,2015,31,(22):2440-2442.
[2] Bleda S,De HJ,Varela C,et al.C-reactive protein and endovascular treatment of lower limb peripheral artery disease:an independent prognostic factor.[J].J Endovascular Therapy,2015,22(2):233-239.
[3] 李前进.不同介入术式治疗下肢动脉硬化闭塞症临床分析[J].解放军医药杂志,2016,28(7):74-77.
[4] 陈波,马军,王海涛,等.介入技术在下肢动脉硬化闭塞症合并血栓形成中的应用[J].现代生物医学进展,2016,16(2):275-277.
[5] 中华医学会外科学分会血管外科学组.下肢动脉硬化闭塞症诊治指南[J].中华医学杂志,2015,95(24):145-151.
[6] 丁明超,李芳,王斌,等.无流出道显影的下肢动脉闭塞症腔内血管成形治疗的预探索[J].介入放射学杂志,2015,25(5):383-387.
[7] Weinberg I,Weinberg MD.Non-atherosclerotic arterial disorders of the lower extremities[J].Circulation,2015,126(2):213-222.
[8] 曹广信,汲武广,胡潍青,等.膝下动脉闭塞性病变40例腔内治疗的疗效分析[J].中华老年多器官疾病杂志,2016,15(3):206-210.
[9] 吴鹏,冯惠岗,陈汉威.血管成形术治疗下肢动脉硬化闭塞的预后因素分析[J].医学影像学杂志,2015,22(6):1091-1094.
[10] 吴元兵,朱云峰,葛红卫,等.下肢动脉硬化闭塞症腔内治疗后支架内再狭窄的治疗[J].中国普通外科杂志,2015,24(12):1687-1690.
[11] 王翔,陈国君,洪毅,等.血管腔内超声在下肢动脉复杂病变治疗中的初步应用[J].中国临床医学,2016,23(2):179-182.
[12] 骆曦图,刘正军.CDT联合腔内血管成形术治疗下肢动脉硬化闭塞症分析[J].西南国防医药,2017,27(1):70-72.
[13] 李春民,姜双鹏,张望德.症状性锁骨下动脉狭窄或闭塞的腔内治疗效果分析[J].中华老年多器官疾病杂志,2016,15(3):178-181.
[14] Darling JD,Mccallum JC,Soden PA,et al.Results for primary bypass versus primary angioplasty/stent for lower extremity chronic limb-threatening ischemia[J].J Vasc Surg,2017,66(2):466-475.
[15] 王荣勤,王蕾.经皮血管腔内球囊扩张成形术及支架置入术治疗急性肠系膜上动脉栓塞的临床研究[J].中华胃肠外科杂志,2017,20(8):939-940.
[16] 何涛,戎红旗,李云松,等.阿托伐他汀预防下肢动脉硬化闭塞症腔内治疗后再狭窄的效果分析[J].中国综合临床,2015,31(10):928-931.
[17] Li FQ,Li L,He XW,et al.Percutaneous transluminal angioplasty combined with intra-arterial thrombolysis to treat lower-extremity arterial occlusion in thromboangitis[J].Int Angiol,2016,35(5):440-445.
[18] 牛国浩,钱俊甫,李书旺.经皮血管腔内支架成形术联合溶栓治疗对主髂动脉狭窄或闭塞患者踝肱指数的影响[J].中国循环杂志,2018,25(4):351-354.
[19] 黄学卿,王黎洲,周石,等.血管重建治疗血液透析并发下肢动脉硬化闭塞症患者预后分析[J].介入放射学杂志,2017,26(2):118-122.
[20] Kashou AH,Braiteh N,Zgheib A,et al.Acute aortoiliac occlusive disease during percutaneous transluminal angioplasty in the setting of ST-elevation myocardial infarction:a case report[J].J Med Case Rep,2018,12(1):6.
[21] 牛晓阳,王兵,丁语,等.杂交手术治疗TASCⅡC/D型股腘动脉硬化闭塞症(附45例报告)[J].山东医药,2017,57(31):75-78.
[22] 邱伟权.下肢动脉硬化闭塞症患者介入治疗后活动水平研究[J].浙江医学,2016,38(11):876-877.
[2] Bleda S,De HJ,Varela C,et al.C-reactive protein and endovascular treatment of lower limb peripheral artery disease:an independent prognostic factor.[J].J Endovascular Therapy,2015,22(2):233-239.
[3] 李前进.不同介入术式治疗下肢动脉硬化闭塞症临床分析[J].解放军医药杂志,2016,28(7):74-77.
[4] 陈波,马军,王海涛,等.介入技术在下肢动脉硬化闭塞症合并血栓形成中的应用[J].现代生物医学进展,2016,16(2):275-277.
[5] 中华医学会外科学分会血管外科学组.下肢动脉硬化闭塞症诊治指南[J].中华医学杂志,2015,95(24):145-151.
[6] 丁明超,李芳,王斌,等.无流出道显影的下肢动脉闭塞症腔内血管成形治疗的预探索[J].介入放射学杂志,2015,25(5):383-387.
[7] Weinberg I,Weinberg MD.Non-atherosclerotic arterial disorders of the lower extremities[J].Circulation,2015,126(2):213-222.
[8] 曹广信,汲武广,胡潍青,等.膝下动脉闭塞性病变40例腔内治疗的疗效分析[J].中华老年多器官疾病杂志,2016,15(3):206-210.
[9] 吴鹏,冯惠岗,陈汉威.血管成形术治疗下肢动脉硬化闭塞的预后因素分析[J].医学影像学杂志,2015,22(6):1091-1094.
[10] 吴元兵,朱云峰,葛红卫,等.下肢动脉硬化闭塞症腔内治疗后支架内再狭窄的治疗[J].中国普通外科杂志,2015,24(12):1687-1690.
[11] 王翔,陈国君,洪毅,等.血管腔内超声在下肢动脉复杂病变治疗中的初步应用[J].中国临床医学,2016,23(2):179-182.
[12] 骆曦图,刘正军.CDT联合腔内血管成形术治疗下肢动脉硬化闭塞症分析[J].西南国防医药,2017,27(1):70-72.
[13] 李春民,姜双鹏,张望德.症状性锁骨下动脉狭窄或闭塞的腔内治疗效果分析[J].中华老年多器官疾病杂志,2016,15(3):178-181.
[14] Darling JD,Mccallum JC,Soden PA,et al.Results for primary bypass versus primary angioplasty/stent for lower extremity chronic limb-threatening ischemia[J].J Vasc Surg,2017,66(2):466-475.
[15] 王荣勤,王蕾.经皮血管腔内球囊扩张成形术及支架置入术治疗急性肠系膜上动脉栓塞的临床研究[J].中华胃肠外科杂志,2017,20(8):939-940.
[16] 何涛,戎红旗,李云松,等.阿托伐他汀预防下肢动脉硬化闭塞症腔内治疗后再狭窄的效果分析[J].中国综合临床,2015,31(10):928-931.
[17] Li FQ,Li L,He XW,et al.Percutaneous transluminal angioplasty combined with intra-arterial thrombolysis to treat lower-extremity arterial occlusion in thromboangitis[J].Int Angiol,2016,35(5):440-445.
[18] 牛国浩,钱俊甫,李书旺.经皮血管腔内支架成形术联合溶栓治疗对主髂动脉狭窄或闭塞患者踝肱指数的影响[J].中国循环杂志,2018,25(4):351-354.
[19] 黄学卿,王黎洲,周石,等.血管重建治疗血液透析并发下肢动脉硬化闭塞症患者预后分析[J].介入放射学杂志,2017,26(2):118-122.
[20] Kashou AH,Braiteh N,Zgheib A,et al.Acute aortoiliac occlusive disease during percutaneous transluminal angioplasty in the setting of ST-elevation myocardial infarction:a case report[J].J Med Case Rep,2018,12(1):6.
[21] 牛晓阳,王兵,丁语,等.杂交手术治疗TASCⅡC/D型股腘动脉硬化闭塞症(附45例报告)[J].山东医药,2017,57(31):75-78.
[22] 邱伟权.下肢动脉硬化闭塞症患者介入治疗后活动水平研究[J].浙江医学,2016,38(11):876-877.