中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2012年
8期
704-708
,共5页
梁刚柱%张福先%罗小云%张昌明%胡路%冯亚平%牛鹿原%张欢%马兵兵%齐浩山%郭梅梅%龙燕妤%李海磊
樑剛柱%張福先%囉小雲%張昌明%鬍路%馮亞平%牛鹿原%張歡%馬兵兵%齊浩山%郭梅梅%龍燕妤%李海磊
량강주%장복선%라소운%장창명%호로%풍아평%우록원%장환%마병병%제호산%곽매매%룡연여%리해뢰
动脉闭塞性疾病%股动脉%血管成形术,气囊%移植物闭塞,血管%噻氯匹定%华法林
動脈閉塞性疾病%股動脈%血管成形術,氣囊%移植物閉塞,血管%噻氯匹定%華法林
동맥폐새성질병%고동맥%혈관성형술,기낭%이식물폐새,혈관%새록필정%화법림
Arterial occlusive disease%Femoral artery%Angioplasty,balloon%Graft occlusion,vascular%Ticlopidine%Warfarin
目的 对比单用抗血小板药物硫酸氯吡格雷(氯吡格雷)与抗凝药物华法林联合氯吡格雷两种抗栓治疗策略对预防股腘动脉经皮腔内血管成形术(PTA)术后再狭窄的疗效.方法 将2008年1月至2009年5月就诊的50例股腘动脉病变患者在术前随机分为单药组(单药组25例30条肢体)与联合组(联合组25例33条肢体),接受下肢动脉PTA治疗后,分别采取不同的术后药物治疗.术后第3、6、12个月随访患肢靶血管再狭窄程度和临床结局.结果 随访3个月单药组再狭窄率16.7％,联合组再狭窄率18.2％,两组间差异无统计学意义(x2=0.025,P=0.874)；6个月单药组累积再狭窄率36.7％,联合组累积再狭窄率36.4％,两组间差异无统计学意义(x2=0.001,P=0.98)；12个月单药组累积再狭窄率53.3％,联合组累积再狭窄率42.4％,两组间差异无统计学意义(x2 =0.75,P=0.387).对重症肢体缺血亚组进行分析,随访12个月,单药组累积再狭窄率为8/10,联合组累积再狭窄率为6/12,两组间差异无统计学意义(x2=1.023,P=0.312).结论 股腘动脉PTA或PTA+支架植入术后单用氯吡格雷与氯吡格雷联合华法林有相似的早中期血管累积再狭窄率.
目的 對比單用抗血小闆藥物硫痠氯吡格雷(氯吡格雷)與抗凝藥物華法林聯閤氯吡格雷兩種抗栓治療策略對預防股腘動脈經皮腔內血管成形術(PTA)術後再狹窄的療效.方法 將2008年1月至2009年5月就診的50例股腘動脈病變患者在術前隨機分為單藥組(單藥組25例30條肢體)與聯閤組(聯閤組25例33條肢體),接受下肢動脈PTA治療後,分彆採取不同的術後藥物治療.術後第3、6、12箇月隨訪患肢靶血管再狹窄程度和臨床結跼.結果 隨訪3箇月單藥組再狹窄率16.7％,聯閤組再狹窄率18.2％,兩組間差異無統計學意義(x2=0.025,P=0.874)；6箇月單藥組纍積再狹窄率36.7％,聯閤組纍積再狹窄率36.4％,兩組間差異無統計學意義(x2=0.001,P=0.98)；12箇月單藥組纍積再狹窄率53.3％,聯閤組纍積再狹窄率42.4％,兩組間差異無統計學意義(x2 =0.75,P=0.387).對重癥肢體缺血亞組進行分析,隨訪12箇月,單藥組纍積再狹窄率為8/10,聯閤組纍積再狹窄率為6/12,兩組間差異無統計學意義(x2=1.023,P=0.312).結論 股腘動脈PTA或PTA+支架植入術後單用氯吡格雷與氯吡格雷聯閤華法林有相似的早中期血管纍積再狹窄率.
목적 대비단용항혈소판약물류산록필격뢰(록필격뢰)여항응약물화법림연합록필격뢰량충항전치료책략대예방고객동맥경피강내혈관성형술(PTA)술후재협착적료효.방법 장2008년1월지2009년5월취진적50례고객동맥병변환자재술전수궤분위단약조(단약조25례30조지체)여연합조(연합조25례33조지체),접수하지동맥PTA치료후,분별채취불동적술후약물치료.술후제3、6、12개월수방환지파혈관재협착정도화림상결국.결과 수방3개월단약조재협착솔16.7％,연합조재협착솔18.2％,량조간차이무통계학의의(x2=0.025,P=0.874)；6개월단약조루적재협착솔36.7％,연합조루적재협착솔36.4％,량조간차이무통계학의의(x2=0.001,P=0.98)；12개월단약조루적재협착솔53.3％,연합조루적재협착솔42.4％,량조간차이무통계학의의(x2 =0.75,P=0.387).대중증지체결혈아조진행분석,수방12개월,단약조루적재협착솔위8/10,연합조루적재협착솔위6/12,량조간차이무통계학의의(x2=1.023,P=0.312).결론 고객동맥PTA혹PTA+지가식입술후단용록필격뢰여록필격뢰연합화법림유상사적조중기혈관루적재협착솔.
Objective Using two antithrombotic treatment (clopidogrel vs.clopidogrel combined warfarin ) strategies after femoral-popliteal artery angioplasty prospectively,to evaluate which strategy is more effective for the restenosis prevention. Methods Totally 50 patients referred for endovascular treatment (including the percutaneous transluminal angioplasty (PTA) and stent implantation ) of the superficial femoral artery and popliteal artery from January 2008 to May 2009 were randomly divided into clopidogrel group (group A,25 cases,30 limbs) and clopidogrel plus warfarin group (group B,25 eases,33 limbs)before operation. Clinical outcomes and restenosis rate of the target lesions were evaluated at 3,6 and 12 months after operation.Results Totally 88 patients were screened for participation in the study,56 patients were included after the follow-up of 12 months.At 3 months,the rates of restenosis were 16.7％ in group A and 18.2％ in group B (x2 =0.0.25,P =0.874 ).At 6 months,the accumulated restenosis rates were 36.7％ in group A and 36.4％ in group B ( x2 =0.001,P =0.98).At 12 months,the accumulated restenosis rates were 53.3％ in group A and 42.4％ in group B (x2 =0.75,P=0.387).Analysis for the critical limb ischemia sub-group showed that follow-up of 12 months,the accumulated restenosis rate was 8/10 in group A and 6/12 in group B ( x2 =1.023,P =0.312 ). Conclusion The elopidogrel alone treatment for PTA or PTA plus stent implantation of femoral popliteal artery has no statistically significant difference in comparison with the clopidogrel combined warfarin treatment in terms of the cumulative vascular restenosis rate at 3,6,12 months postoperatively.
