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)
2013年
2期
90-93
,共4页
蔡志新%李晓强%尚斌%钱爱民%孟庆友
蔡誌新%李曉彊%尚斌%錢愛民%孟慶友
채지신%리효강%상빈%전애민%맹경우
下肢动脉硬化闭塞症%股腘动脉%腔内治疗%治疗效果
下肢動脈硬化閉塞癥%股腘動脈%腔內治療%治療效果
하지동맥경화폐새증%고객동맥%강내치료%치료효과
Arteriosclerosis obliterans of lower extremities%Femoropopliteal artery%Endovascular treatment%Treatment outcome
目的探讨血管腔内治疗技术在股腘动脉硬化闭塞症患者中的临床应用及其疗效。方法回顾性分析2010年7月~2012年8月我科收治的40例(47条肢体)股腘动脉硬化闭塞症（病变长度≥10cm）患者的临床资料。采用经皮腔内血管成形术及支架植入术，术后应用踝/肱指数（ABI）、Fontain 分级、保肢率、一期通畅率等综合评估治疗效果。结果38例（95%）手术成功。术后症状改善率95%，术后 ABI 为0.83±0.16，与术前（0.35±0.08）比较差异有统计学意义(P <0.01)。38例患者 Fontaine 分级均上升1级或以上。37例患者获得随访，随访时间12~24个月，1例术后2个月出现肢体缺血坏疽行截肢术，4例术后3~6个月症状复发，行第2次介入治疗，其余患者症状均无加重或复发。总体保肢率为95%，随访6个月时的一期通畅率为86.4%。结论股腘动脉硬化闭塞症腔内治疗是一种安全、有效的方法。熟练掌握腔内操作技术是提高技术成功率和维持近期通畅率的关键。
目的探討血管腔內治療技術在股腘動脈硬化閉塞癥患者中的臨床應用及其療效。方法迴顧性分析2010年7月~2012年8月我科收治的40例(47條肢體)股腘動脈硬化閉塞癥（病變長度≥10cm）患者的臨床資料。採用經皮腔內血管成形術及支架植入術，術後應用踝/肱指數（ABI）、Fontain 分級、保肢率、一期通暢率等綜閤評估治療效果。結果38例（95%）手術成功。術後癥狀改善率95%，術後 ABI 為0.83±0.16，與術前（0.35±0.08）比較差異有統計學意義(P <0.01)。38例患者 Fontaine 分級均上升1級或以上。37例患者穫得隨訪，隨訪時間12~24箇月，1例術後2箇月齣現肢體缺血壞疽行截肢術，4例術後3~6箇月癥狀複髮，行第2次介入治療，其餘患者癥狀均無加重或複髮。總體保肢率為95%，隨訪6箇月時的一期通暢率為86.4%。結論股腘動脈硬化閉塞癥腔內治療是一種安全、有效的方法。熟練掌握腔內操作技術是提高技術成功率和維持近期通暢率的關鍵。
목적탐토혈관강내치료기술재고객동맥경화폐새증환자중적림상응용급기료효。방법회고성분석2010년7월~2012년8월아과수치적40례(47조지체)고객동맥경화폐새증（병변장도≥10cm）환자적림상자료。채용경피강내혈관성형술급지가식입술，술후응용과/굉지수（ABI）、Fontain 분급、보지솔、일기통창솔등종합평고치료효과。결과38례（95%）수술성공。술후증상개선솔95%，술후 ABI 위0.83±0.16，여술전（0.35±0.08）비교차이유통계학의의(P <0.01)。38례환자 Fontaine 분급균상승1급혹이상。37례환자획득수방，수방시간12~24개월，1례술후2개월출현지체결혈배저행절지술，4례술후3~6개월증상복발，행제2차개입치료，기여환자증상균무가중혹복발。총체보지솔위95%，수방6개월시적일기통창솔위86.4%。결론고객동맥경화폐새증강내치료시일충안전、유효적방법。숙련장악강내조작기술시제고기술성공솔화유지근기통창솔적관건。
Objective To explore the clinical application and efficacy of endovascular treatment of femoropopliteal atherosclerotic occlusive disease. Methods Forty cases (47 limbs)with femoropopliteal atherosclerotic occlusive disease(the length of occlusive lesions was more than 10.0 cm) were enrolled from July 2010 to August 2012. The ankle brachial index (ABI), limb salvage rate and primary patency rate were evaluated at 6 month after operation. Results The surgery success rate was 95%, the clinical ameliorated rate was 95%, the limb salvage rate was 95%, and the primary patency rate was 86.4%. There was significant difference in ABI before and after the therapy (0.35±0.08 vs 0.83±0.16, P < 0.01). Thirty-seven cases were followed-up for 12 to 24 months. One patient accepted amputation because limb ischemia and gangrene two months later, four patients needed the secondary interventional therapy because clinically relapsed after operation from 3 to 6 months. No recurrence occurred in the other patients. The overall limb salvage rate was 95%, primary patency rate was 86.4% at 6 months after operation. Conclusion Endovascular treatment of femoropopliteal atherosclerotic occlusive disease is effective and safe. Skillful endovascular technique is important for improving technical success rate and maintaining eary patency rate.
