CAJ | 학술논문

目的：通过与单独球囊扩张和支架植入比较，评价超声消融联合球囊扩张和支架植入治疗下肢动脉长段闭塞的疗效及安全性。方法筛选我院2010年1月～2013年9月下肢动脉闭塞症患者，选取满足条件的40例存在长段动脉闭塞患者。随机分为2组，治疗组采用超声消融联合球囊扩张和支架植入治疗，对照组采用单纯球囊扩张和支架植入治疗。观察治疗组与对照组两组术前、术后2周患者跛行距离、足部皮温及ABI变化。结果 A组与B组中共11例患者下肢溃烂，术后经局部换药后2周内全部愈合。 A组成功率为97．0％，而B组成功率为87．1％．A组和B组术后2周与术前相比，足部皮温、ABI及间歇性跛行距离均得到明显改善，具有统计学意义（P＜0．05）。术后2周A组与B组比较，足部皮温、ABI及间歇性跛行距离改善无统计学意义（P＞0．05）。术后造影A组较B组有更丰富的侧枝循环。手术并发症：A组并发症发生率6．1％，B组并发症发生率19．3％．结论血管内超声消融联合球囊扩张成形和支架植入治疗下肢动脉完全闭塞比单纯球囊扩张和支架植入的成功率高、并发症少。血管内超声消融联合球囊扩张成形和支架植入治疗下肢动脉完全闭塞的长期疗效有待进一步观察。
목적：통과여단독구낭확장화지가식입비교，평개초성소융연합구낭확장화지가식입치료하지동맥장단폐새적료효급안전성。방법사선아원2010년1월～2013년9월하지동맥폐새증환자，선취만족조건적40례존재장단동맥폐새환자。수궤분위2조，치료조채용초성소융연합구낭확장화지가식입치료，대조조채용단순구낭확장화지가식입치료。관찰치료조여대조조량조술전、술후2주환자파행거리、족부피온급ABI변화。결과 A조여B조중공11례환자하지궤란，술후경국부환약후2주내전부유합。 A조성공솔위97．0％，이B조성공솔위87．1％．A조화B조술후2주여술전상비，족부피온、ABI급간헐성파행거리균득도명현개선，구유통계학의의（P＜0．05）。술후2주A조여B조비교，족부피온、ABI급간헐성파행거리개선무통계학의의（P＞0．05）。술후조영A조교B조유경봉부적측지순배。수술병발증：A조병발증발생솔6．1％，B조병발증발생솔19．3％．결론혈관내초성소융연합구낭확장성형화지가식입치료하지동맥완전폐새비단순구낭확장화지가식입적성공솔고、병발증소。혈관내초성소융연합구낭확장성형화지가식입치료하지동맥완전폐새적장기료효유대진일보관찰。
Objective To explore the complications , efficacy and safety of ultrasound ablation combined with balloon angioplasty and stens by comparing with the implantation of balloon angioplasty and stents .Methods Four-ty patients that met the conditions of long artery occlusion were enrolled and divided into two groups randomly .The treat-ment group received ultrasound ablation combined balloon and stent implantation ,and the control group received balloon angioplasty and stent implantation .The claudication distance ,foot skin temperature and ABI of patients in the preopera-tive and postoperative 2 weeks were Observed .Results The ulcers of 11 patients in Group A and Group B were cured after 2 weeks.In the groupA,the success rate was 97.0%.While in the group B,the success rate was 87.1%.Compared with preoperative and postoperative 2 weeks,the foot skin temperature ,ABI and intermittent claudication distance were significantly improved,with statistical significance in the group A and the group B (P<0.05).Compared the group A with the group B,the foot skin temperature,ABI and intermittent claudication distance were not statistically significant improvement in postoperative 2 weeks(P>0.05).The group A had richer circulation than the group B .The complication rate of group A was 6 .1%, and the group B was 19 .3%.Conclusions 1 Intravascular ultrasound ablation combined balloon and stent implantation has a higher success rate and fewer complications than that of balloon and stent implanta -tion for long period of lower limb artery occlusion .2 The long-term efficacy of intravascular ultrasound ablation combined balloon and stent implantation for lower artery occlusion remains to be seen .