中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2010年
10期
811-814
,共4页
动脉硬化,闭塞性%糖尿病,2型%血管外科手术
動脈硬化,閉塞性%糖尿病,2型%血管外科手術
동맥경화,폐새성%당뇨병,2형%혈관외과수술
Arteriosclerosis obliterans%Diabetes mellitus,type 2%Vascular surgical procedures
目的 明确股胴动脉病变TASCⅡ分级、流出道评分、影响动脉硬化危险因素与外科治疗股浅动脉硬化闭塞症术后疗效的相关性.方法 回顾性分析2006年1月至2009年9月北京同仁医院对股胭动脉硬化闭塞症行股胭动脉段介入或手术治疗142例患者的临床资料.采用TASCⅡ分级标准对股胴动脉段病变分级;使用流出道评分标准对胫腓动脉进行膝下流出道评分.随访患者术后疗效,用Kaplan-Meier法计算一期通畅率,用COX回归分析病变TASCⅡ分级、流出道评分、各种动脉硬化危险因素与术后一期通畅率相关性.结果 本组142例(197条患肢).其中外科手术治疗50例(58条患肢);介入治疗99例(139条患肢).随访患者141例(196条患肢),随访率90.8%.术后随访时间1～26个月,中位随访时间13个月.经COX回归分析,术前股浅动脉病变TASCⅡ分级(RR=1.471,P=0.012)、流出道评分(RR=1.190,P=0.004)、2型糖尿病(RR=2.320,P=0.019)为影响外科治疗股浅动脉病变术后一期通畅率的因素. 结论术前TASCⅡ分级级别较高、流出道评分分值较高及患有2型糖尿病的患者,股浅动脉病变术后一期通畅率不佳.
目的 明確股胴動脈病變TASCⅡ分級、流齣道評分、影響動脈硬化危險因素與外科治療股淺動脈硬化閉塞癥術後療效的相關性.方法 迴顧性分析2006年1月至2009年9月北京同仁醫院對股胭動脈硬化閉塞癥行股胭動脈段介入或手術治療142例患者的臨床資料.採用TASCⅡ分級標準對股胴動脈段病變分級;使用流齣道評分標準對脛腓動脈進行膝下流齣道評分.隨訪患者術後療效,用Kaplan-Meier法計算一期通暢率,用COX迴歸分析病變TASCⅡ分級、流齣道評分、各種動脈硬化危險因素與術後一期通暢率相關性.結果 本組142例(197條患肢).其中外科手術治療50例(58條患肢);介入治療99例(139條患肢).隨訪患者141例(196條患肢),隨訪率90.8%.術後隨訪時間1～26箇月,中位隨訪時間13箇月.經COX迴歸分析,術前股淺動脈病變TASCⅡ分級(RR=1.471,P=0.012)、流齣道評分(RR=1.190,P=0.004)、2型糖尿病(RR=2.320,P=0.019)為影響外科治療股淺動脈病變術後一期通暢率的因素. 結論術前TASCⅡ分級級彆較高、流齣道評分分值較高及患有2型糖尿病的患者,股淺動脈病變術後一期通暢率不佳.
목적 명학고동동맥병변TASCⅡ분급、류출도평분、영향동맥경화위험인소여외과치료고천동맥경화폐새증술후료효적상관성.방법 회고성분석2006년1월지2009년9월북경동인의원대고연동맥경화폐새증행고연동맥단개입혹수술치료142례환자적림상자료.채용TASCⅡ분급표준대고동동맥단병변분급;사용류출도평분표준대경비동맥진행슬하류출도평분.수방환자술후료효,용Kaplan-Meier법계산일기통창솔,용COX회귀분석병변TASCⅡ분급、류출도평분、각충동맥경화위험인소여술후일기통창솔상관성.결과 본조142례(197조환지).기중외과수술치료50례(58조환지);개입치료99례(139조환지).수방환자141례(196조환지),수방솔90.8%.술후수방시간1～26개월,중위수방시간13개월.경COX회귀분석,술전고천동맥병변TASCⅡ분급(RR=1.471,P=0.012)、류출도평분(RR=1.190,P=0.004)、2형당뇨병(RR=2.320,P=0.019)위영향외과치료고천동맥병변술후일기통창솔적인소. 결론술전TASCⅡ분급급별교고、류출도평분분치교고급환유2형당뇨병적환자,고천동맥병변술후일기통창솔불가.
Objective The purpose of this study is to determine whether the TransAtlantic InterSociety Consensus (TASC) criteria (Ⅱ-2007 versions), the Society of Vascular Surgery (SVS) runoff score or risk factors for peripheral arterial disease were correlated with postoperative outcome of superficial femoral artery occlusive disease. Methods From January 2006 to September 2009, patients who suffered from lower extremity atherosclerosis occlusion disease and underwent endovascular or surgical therapy in superficial femoral artery segment were reviewed retrospectively at Beijing Tongren Hospital. Femoralpopliteal artery lesions were graded according to the TASC Ⅱ criteria. Runoff scores were determined in infrapopliteal artery segment lesions. All patients were followed up. Kaplan-Meier method was applied to calculate primary patency rate, and COX regression analysis was used to determine if TASC Ⅱ classification,runoff score, or factors for peripheral arterial disease affected primary patency rate. Results 142 patients (197 limbs) were followed up after treatment at 1 month, 3 months, 6 months, and every 6 months thereafter. Median follow-up time was 13 months. By Cox regression analysis, TASC Ⅱ classification(RR =1.471,P = 0. 012 ), runoff score ( RR = 1.190, P = 0. 004 ), and type 2 diabetic mellitus ( RR = 2. 320, P =0.019) significantly affected primary patency. Conclusions Postoperative poor patency rates are associated with higher degree of the TASC Ⅱ lesions, poor initial runoff score, and type 2 diabetic mellitus in patients of superfical femoral artery occlusive disease.
