中国血管外科杂志（电子版）
中國血管外科雜誌（電子版）
중국혈관외과잡지（전자판）
CHINESE JOURNAL OF VASCULAR SURGERY(ELECTRONIC VERSION)
2014年
1期
41-44
,共4页
王佩双%胡何节%方征东%王晓天
王珮雙%鬍何節%方徵東%王曉天
왕패쌍%호하절%방정동%왕효천
动脉硬化性闭塞%股腘动脉%腔内治疗%旁路转流术
動脈硬化性閉塞%股腘動脈%腔內治療%徬路轉流術
동맥경화성폐새%고객동맥%강내치료%방로전류술
Arteriosclerosis obliterans%Femoropopliteal artery%Endovascular therapy%Bypass surgery
目的：探讨股腘动脉闭塞行腔内治疗和旁路转流术的临床疗效。方法回顾性分析2008年1月至2011年12月本院收治的60例（67条肢体）股腘动脉闭塞（TASCⅡC/D型）患者的临床资料，其中腔内治疗41例（47条肢体，腔内治疗组），旁路转流术19例(20条肢体，旁路转流术组)，比较两组患者的手术时间、术中出血量、术后恢复行走时间、踝肱指数（ABI）及随访1～4年的通畅率及保肢率。结果腔内治疗组术中出血量、手术时间及术后恢复行走时间明显少于旁路转流术组（P＜0.01）；两组术后ABI及技术成功率比较差异无统计学意义（P＞0.05）。术后6～12个月的随访，腔内治疗组一期通畅率与旁路转流术组的通畅率比较，差异无统计学意义（43.6%v s 50.0%，P＞0.05）；术后18～48个月的随访，腔内治疗组二期通畅率及保肢率高于旁路转流术组，两组比较差异有统计学意义（79.5%v s 50.0%，P＜0.05）。结论腔内治疗与旁路转流术治疗TASCⅡC/D型股腘动脉闭塞患者在短期内均能取得满意临床疗效及较好通畅率；但腔内治疗有着微创、术后恢复快等优点，且具有可重复操作性，有助于提高患肢远期血管通畅率。
目的：探討股腘動脈閉塞行腔內治療和徬路轉流術的臨床療效。方法迴顧性分析2008年1月至2011年12月本院收治的60例（67條肢體）股腘動脈閉塞（TASCⅡC/D型）患者的臨床資料，其中腔內治療41例（47條肢體，腔內治療組），徬路轉流術19例(20條肢體，徬路轉流術組)，比較兩組患者的手術時間、術中齣血量、術後恢複行走時間、踝肱指數（ABI）及隨訪1～4年的通暢率及保肢率。結果腔內治療組術中齣血量、手術時間及術後恢複行走時間明顯少于徬路轉流術組（P＜0.01）；兩組術後ABI及技術成功率比較差異無統計學意義（P＞0.05）。術後6～12箇月的隨訪，腔內治療組一期通暢率與徬路轉流術組的通暢率比較，差異無統計學意義（43.6%v s 50.0%，P＞0.05）；術後18～48箇月的隨訪，腔內治療組二期通暢率及保肢率高于徬路轉流術組，兩組比較差異有統計學意義（79.5%v s 50.0%，P＜0.05）。結論腔內治療與徬路轉流術治療TASCⅡC/D型股腘動脈閉塞患者在短期內均能取得滿意臨床療效及較好通暢率；但腔內治療有著微創、術後恢複快等優點，且具有可重複操作性，有助于提高患肢遠期血管通暢率。
목적：탐토고객동맥폐새행강내치료화방로전류술적림상료효。방법회고성분석2008년1월지2011년12월본원수치적60례（67조지체）고객동맥폐새（TASCⅡC/D형）환자적림상자료，기중강내치료41례（47조지체，강내치료조），방로전류술19례(20조지체，방로전류술조)，비교량조환자적수술시간、술중출혈량、술후회복행주시간、과굉지수（ABI）급수방1～4년적통창솔급보지솔。결과강내치료조술중출혈량、수술시간급술후회복행주시간명현소우방로전류술조（P＜0.01）；량조술후ABI급기술성공솔비교차이무통계학의의（P＞0.05）。술후6～12개월적수방，강내치료조일기통창솔여방로전류술조적통창솔비교，차이무통계학의의（43.6%v s 50.0%，P＞0.05）；술후18～48개월적수방，강내치료조이기통창솔급보지솔고우방로전류술조，량조비교차이유통계학의의（79.5%v s 50.0%，P＜0.05）。결론강내치료여방로전류술치료TASCⅡC/D형고객동맥폐새환자재단기내균능취득만의림상료효급교호통창솔；단강내치료유착미창、술후회복쾌등우점，차구유가중복조작성，유조우제고환지원기혈관통창솔。
Objective To investigate the clinical effects of endovascular therapy and bypass surgery for femoropopliteal atherosclerotic occlusive disease of the lower limbs. Methods The data of 60 patients (67 limbs) with TASCⅡC/D femoropopliteal artery disease in our centre from Jan. 2008 to Dec. 2011 were analyzed retrospectively. All cases were divided into two groups based on treatment:endovascular group (41 cases, 47 limbs) and bypass group (19 cases, 20 limbs). The parameters of the operation time, the blood loss in operation, postoperative recovery of walking time and ankle brachial index (ABI) as well as the patency rate and limb salvage rate during the 1~4 years of follow-up. Results The operation time, the blood loss in operation and postoperative recovery of walking time of endovascular group are lower than those of bypass group (P<0.01). They were no significant differences in ABI and technical success rate between endovascular group and bypass group(P>0.05). During the follow-up with a time of 6~12 months, there were no statistically significant differences in the primary patency rate and limb salvage rate between two groups (43.6%v s 50.0%,P>0.05). However, the secondary patency rate and limb salvage rate of endovascular group are higher than that of bypass group after operation 18~48 months (79.5%v s 50.0%, P<0.05). Conclusions Both the endovascular therapy and bypass surgery can get great clinical effect and high patency rate for TASCⅡC/D arteriosclerotic occlusion of femoropopliteal artery in short-term, but endovascular therapy has better long-term patency rate because of its minimal invasion, rapid postoperative recovery and repetitive operation.
