摘要
目的 探讨近十年下肢动脉硬化闭塞症外科治疗方法及预后的变化.方法 回顾性分析2002年1月至2011年12月首都医科大学宣武医院血管外科收治并获得随访的下肢动脉硬化闭塞症患者的临床资料,对比分析2002至2006年和2007至2011年接受手术治疗患者的一般资料、危险因素、病情程度、病变解剖特点及治疗方法,按前后两个时间段分为2002-2006年组和2007-2011年组,观察两个时间段手术治疗方法的变化及对预后的影响,组间比较采用χ2检验、Fisher确切概率法和t检验.结果 十年间共收治患者2 051例,其中1 613例（1 845条肢体）获得随访.2002至2006年组接受传统手术治疗170例（47.49％）,介入治疗72例（20.11％）,干细胞治疗116例（32.40％）,基因药物治疗0例;2007至2011年组接受传统手术治疗275例（18.49％）,介入治疗1 022例（68.73％）,干细胞治疗123例（8.27％）,基因药物治疗67例（4.51％）.前组的保肢率明显低于后组（87.15％比93.41％,χ2=15.71,P=0.000）,但两组的生存率差异无统计学意义（84.67％比84.31％,χ2=0.02,P=0.880）.结论 近年来随着介入新器材的不断面世和基因药物临床研究的出现,下肢动脉硬化闭塞症患者接受动脉腔内介入治疗的比例逐渐增加,患者的保肢率提高.
Objective To analyze the trends in treatments of lower extremity peripheral arterial disease and their prognosis in the recent 10 years.Methods Clinical data of inpatients with lower extremity peripheral arterial disease who received surgical treatments in Xuanwu Hospital from January 2002 to December 2011 were analyzed retrospectively.Patients were stratified into two groups （group 1：from 2002 to 2006,group 2：from 2007 to 2011）.The demographics,risk factors,clinical presentation,lesion anatomy,therapies,limb salvage and survival were observed.χ2 test,Fisher exact test,and t test were used to compare the data between the two groups.Results From 2002 to 2006,170 limbs （47.49%） underwent conventional bypass surgery,72 limbs （20.11%） underwent endovascular interventions and the rest 116 limbs （32.40%） received stem cell treatment.While from 2007 to 2011,the percentages were 18.49%,68.73%,8.27%,respectively.Furthermore,gene-based drug appeared,67 limbs （4.51%） underwent the new treatment.Former group had decreased limb salvage rates compared with latter group （87.15% vs.93.41%,χ2 =15.71,P =0.000）.However,survival rates did not differ from the two groups （84.67% vs.84.31%,χ2 =0.02,P =0.880）.Conclusion With the appearance of new medical instruments and operating methods,the percentage of the patients with lower extremity peripheral arterial disease receive endovascular interventions increases,with a improved limb salvage rates.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2015年第4期305-309,共5页
Chinese Journal of Surgery
基金
首都十大危险疾病科技成果推广项目，首都临床特色应用研究资助项目
关键词
动脉硬化
闭塞性
血管成形术
血管假体植入
干细胞移植
Arteriosclerosis obliterans
Angioplasty
Blood vessel prosthesis implantation
Stem cell transplantation
作者简介
通信作者：谷涌泉，Email：guyq66@aliyun．com
