CAJ | 학술논문

目的观察下肢动脉硬化闭塞症腔内治疗时采用微穿刺技术建立入路与传统穿刺技术建立入路的相关并发症,比较两种技术的安全性及有效性.方法回顾性分析2007年1月至2012年2月收治的862例下肢动脉硬化闭塞症患者的临床资料,其中385例(463条肢体)采用微穿刺技术建立动脉入路；477例(586条肢体)采用传统18G穿刺针穿刺建立入路.术后采用手法压迫止血或以血管封堵器止血.初期评价终点包括穿刺点局部血肿形成(≥2 cm)、假性动脉瘤形成、医源性动静脉瘘形成、腹膜后血肿以及需要手术修补的动脉贯通伤或血流限制性夹层.结果微穿刺组患者合并有更高的危险因素,然而微穿刺组较传统穿刺组的平均穿刺次数少(3.2±2.3比5.1±3.2,P＜0.05),入路相关总并发症率低(6.2％比6.7％,x2=7.91,P＜0.005).结论下肢动脉硬化闭塞症治疗时,使用微穿刺技术建立动脉入路是安全有效的,其成功率较高,并发症率较低.
목적 관찰하지동맥경화폐새증강내치료시채용미천자기술건립입로여전통천자기술건립입로적상관병발증,비교량충기술적안전성급유효성.방법 회고성분석2007년1월지2012년2월수치적862례하지동맥경화폐새증환자적림상자료,기중385례(463조지체)채용미천자기술건립동맥입로；477례(586조지체)채용전통18G천자침천자건립입로.술후채용수법압박지혈혹이혈관봉도기지혈.초기평개종점포괄천자점국부혈종형성(≥2 cm)、가성동맥류형성、의원성동정맥루형성、복막후혈종이급수요수술수보적동맥관통상혹혈류한제성협층.결과 미천자조환자합병유경고적위험인소,연이미천자조교전통천자조적평균천자차수소(3.2±2.3비5.1±3.2,P＜0.05),입로상관총병발증솔저(6.2％비6.7％,x2=7.91,P＜0.005).결론 하지동맥경화폐새증치료시,사용미천자기술건립동맥입로시안전유효적,기성공솔교고,병발증솔교저.
Objective To compare the clinical results of micropuncture technique and traditional puncture technique in the treatment of lower extremity arteriosclerosis occlusion.Methods From January 2007 to February 2012,862 patients of lower extremity arteriosclerosis occlusion were treated by endovascular technology,385 patients ( 463 limbs ) by 21-G micropuncture technique and 477 patients ( 586 limbs ) by traditional 18-G puncture technique.Access sites were managed with manual pressure hemostasis or a vascular closure device.Primary endpoints included groin hematoma ( ≥ 2 cm),pseudoaneurysm,iatrogenic arteriovenous tistula,retroperitoneal hematoma,vascular perforation requiring repair and blood flow limited dissection.Results Patients assigning to undergo micropuncture technique were at higher risk,there was a significant shorter puncture time required for micropuncture technique vs.traditional puncture technique,(3.2 ± 2.3 vs.5.1 ± 3.2,P ＜ 0.05 ),the overall access site complications rate was lower in micropuncture group ( 6.2％ vs.6.7％,x2 =7.91,P ＜ 0.005 ).Conclusions In lower extremity arteriosclerosis occlusion treatment,arterial access can be completed by micropuncture which was safer and more effective than traditional puncture technique.