J4 ›› 2011, Vol. 37 ›› Issue (1): 122-126.

• 基础研究 • 上一篇    下一篇

介入治疗慢性动脉粥样硬化下肢单一闭塞性疾病的效果评价

 刘亚民, 韩慧, 秦皓, 余莉, 张敏, 冯骏   

  1. 西安交通大学医学院第一附属医院周围血管科|陕西 西安 710061
  • 收稿日期:2010-07-09 出版日期:2011-01-28 发布日期:2011-01-28
  • 通讯作者: 冯 骏(Tel:029-85324128,E-mail:fjcccp@sina.com) E-mail:fjcccp@sina.com
  • 作者简介:刘亚民(1956-)|男|陕西省西安市人|教授|医学博士|主要从事周围血管病方面的研究。

Evaluation of curative effect of interventional therapy for chronic simple atherosclerotic occlusive disease of lower extremity

 LIU Ya-Min, HAN Hui, QIN Hao, YU Li, ZHANG Min, FENG Jun   

  1. Department of Peripheral Vessels,First Affiliated Hospital,Xi’an Jiaotong University,Xi’an 710061,China
  • Received:2010-07-09 Online:2011-01-28 Published:2011-01-28
  • Supported by:

    陕西省卫生厅自然科学基金资助课题(2004C2_51)

摘要:

目的:探讨介入治疗慢性动脉粥样硬化下肢单一闭塞性疾病的疗效以及影响因素。方法:选取慢性动脉粥样硬化下肢单一闭塞性疾病患者56例,按闭塞段分为腹主-髂动脉型17例、髂-股动脉型18例和股腘膝下动脉型21例。应用导管、导丝相配合钝性分离微夹层介入技术行闭塞管腔开通后球囊扩张,出现夹层行支架植入术。结果:经介入治疗后闭塞段开通46例(82.1%),闭塞段未开通症状无改善6例(10.7%),症状较术前加重4例(7.1%)。其中腹主-髂动脉型开通率(16例,94.1%)与髂-股动脉型开通率(16例,88.9%)比较差异无统计学意义(P>0.05),腹主-髂动脉型开通率高于股腘膝下动脉型开通率(14例,66.6%)(P<0.05)。闭塞动脉长度在5~10 cm的患者,腹主-髂动脉型开通率(9例,52.9%)和髂-股动脉型开通率(10例,55.5%)均高于股腘膝下动脉型开通率(7例,33.3%)(P<0.05),而前两型比较差异无统计学意义(P>0.05)。股腘膝下动脉型未开通患者(7例,33.3%)闭塞两端血管侧支代偿血管(≥3支)总数(35支,平均5.00支)多于开通患者(14例,71.4%)侧支代偿血管总数(19支,平均1.36支)(P<0.05)。结论:介入治疗慢性动脉粥样硬化下肢闭塞性疾病安全有效,下肢动脉闭塞位置、闭塞动脉长度和侧支循环建立丰富程度对开通闭塞段有一定影响。

关键词: 动脉粥样硬化;动脉闭塞性疾病;介入治疗;效果评价

Abstract:

Objective
To explore the efficacy and influencing factors of interventional therapy for chronic atherosclerotic occlusive disease of the lower extremity. Methods 56 cases of simple atherosclerotic occlusive disease of lower extremity were divided into 3 types according to the location of occlusion,including 17 cases of abdominal aorta-iliac artery,18 cases of iliac-femoral artery,and 21 cases of femoropopliteal inferior genicular artery. Catheter and guide were combined with blunt dissection and subtle banding were used to dredge the occluded vessels,and the stents were implanted when interlayer appeared. Results  After the treatment,46 cases of occlusion were dredged (82.1%),6 cases remained occluded with the same symptoms (10.7%),and 4 cases had severer symptoms (7.1%). Among the 46 successful cases,there were 16 cases of abdominal aorta-iliac artery (94.1%),16 cases of iliac-femoral artery (88.9%) and 14 cases of femoropopliteal inferior genicular artery(66.6%). There was no statistical difference between the abdominal aorta-iliac artery cases and iliac-femoral artery cases (P>0.05),but the rate of abdominal aorta-iliac artery was higher than that of femoropopliteal inferior aorta-iliac artery (P<0.05).In the successful cases,9 cases of abdominal aorta-iliac artery (52.9%),10 cases of iliac-femoral artery (55.5%) and 7 cases of femoropopliteal inferior genicular artery (33.3%) had 5-10 cm of occlusion,there was no significant difference between the first two types(P>0.05),but there were significant differences between the first two types and the third type (P<0.05).Compared with the 14 dredged cases (71.4%),7 cases (33.3%) of undredged femoropopliteal inferior genicular artery cases had richer compensatory circulation (P<0.05). Conclusion It is safe and effective to treat simple atherosclerotic occlusive disease of the lower extremity with interventional therapy. The location and length of occlusion and the abundance of compensatory circulation have effects on the therapy.

Key words: atherosclerosis;arterial occlusive diseases;interventional therapy;effect evaluation

中图分类号: 

  • R543