摘要
目的回顾性分析血管腔内介入治疗膝下动脉缺血性疾病的疗效，初步总结其技术要点、主要并发症防治与应用价值。方法对2004年11月至2007年7月期间收治的60例（65条肢体）膝下动脉缺血性疾病的患者行膝下病变段动脉球囊扩张（percutaneous transluminal angioplasty，PTA）和／或支架植入（stenting）治疗，观察症状的改善，踝肱指数（ankle／brachial index，ABI）的变化，保肢率以及近期通畅率。结果60例患者（65条肢体）中，技术成功51例，成功率83．3％；临床成功53例，成功率88．3％。症状完全缓解40例（66．7％），部分缓解13例（21．7％），无改善7例（11．6％）；ABI从术前0．40±0．18增加到术后0．91±0．22，两者差异有统计学意义（P〈0．01）。2例膝下截肢，4例足趾截趾，出院时保肢率为91％。随访54例，随访时间10d至30个月，平均（14．5±1．2）个月。2例膝上截肢，2例膝下截肢，2例足趾截趾，保肢率88．9％（48例／54例）；症状复发5例，复发率9．2％，血管再闭塞或再狭窄10例，通畅率81．5％，1年累积通畅率为57．3％。结论腔内介入治疗膝下动脉缺血性疾病安全、可行，近期疗效确切，是该类疾病重要的治疗选择。
＂Objective To＂ evaluate the efficacy of endovascular interventional treatment for infrapopliteal arterial ischemic diseases. Methods Sixty patients （65 limbs） of infrapopliteal arterial ischemia of the lower extremities received percutaneous transluminal angioplasty （PTA） and/or stents implantation from November 2004 to July 2007. The symptoms, changes of ankle / brachial index （ ABI）, limb salvage rate and immediate patent rate were observed. Results PTA /stenting procedure was successful in 51 out of 60 patients （65 limbs） with the technical success rate of 83.3%. Symptoms were improved in 53 cases （ 88.3% ） including complete symptom remission in 40 cases （ 66. 7% ）, partial remission in 13 patients （21.7%）. The procedure failed in 7 cases （11.6%）. In successful cases, AB1 increased from preoperative 0.40 ±0. 18 to postoperative 0.91 ± 0.22 （ P 〈 0.01 ）. The amputation below knee was performed in two cases and toe apodizers in four cases. The limb salvage rate was 91% during the same hospitalization. Discharged 54 cases were followed up with 14. 5 ± 1.2 months, during this period amputation above knee was performed in 2 cases, amputation below knee in 2 cases, and toe apodizers in 2 cases, with a limb salvage rate of 88. 9% （48/54）. Symptoms were recurrent in five cases, with recurrence rate of 9. 2%. Vascular reocclusion or restenosis were found in 10 cases, the patent rate was 81.5% and the cumulative patent rate was 57. 3% in one year. Conclusions Endovascular interventional treatment for infrapopliteal arterial ischemic disease is safe and effective.
出处
《中华普通外科杂志》
CSCD
北大核心
2008年第9期699-701,共3页
Chinese Journal of General Surgery
关键词
动脉闭塞性疾病
血管成形术
缺血
膝下动脉
Arterial occlusive diseases
Angioplasty
Ischemia
infrapopliteal artery
作者简介
通信作者：李晓强，E-mail：flytsg@126．com
