CAJ | 학술논문

目的：探讨髂动脉闭塞合并股动脉长段狭窄或闭塞的腔内治疗的临床效果。方法回顾性选择2011年9月-2013年11月于吉林大学中日联谊医院住院确诊为髂动脉闭塞合并股动脉长段狭窄或闭塞的患者117例，男73例、女44例，平均年龄（64.3±0.6）岁。其中57例行髂动脉球囊扩张﹢支架植入术，股动脉长段病变未做处理，作为A组；60例行髂动脉及股动脉狭窄或闭塞病变血管球囊扩张﹢支架植入术，作为B组。分别于术前和术后当天检查踝肱指数（ ABI）和跛行距离，并于术后1、6、12、18、24个月时检测ABI、患肢血管通畅率、跛行距离、保肢率。结果 A组术后当天ABI为（0.78±0.02），低于B组的（1.03±0.08）（P﹤0.05）；A组术后1、6、12、18个月时ABI低于B组，但术后24个月时高于B组〔（0.60±0.01）和（0.50±0.02），P﹤0.05〕。A组术后6、12、18、24个月时患肢血管通畅率均高于B组（ P﹤0.05）。A组术后当天跛行距离为（521.5±19.7）m，短于B组的（674.7±22.6）m（P﹤0.05）；A组术后1、6、12、18个月时跛行距离均短于B组（P﹤0.05），但术后24个月时A组跛行距离长于B组〔（462.6±12.2） m和（401.4±19.1）m，P﹤0.05〕。随访24个月时A组所有患者肢体均保留，B组有1例患者因病情进展行患肢截肢术（1条肢体）。结论髂动脉闭塞合并股动脉长段血管病变宜首选腔内介入治疗；髂动脉闭塞合并有股动脉长段病变的患肢，单纯处理髂动脉病变的远期效果优于髂股动脉同时处理的远期效果。
목적：탐토가동맥폐새합병고동맥장단협착혹폐새적강내치료적림상효과。방법회고성선택2011년9월-2013년11월우길림대학중일련의의원주원학진위가동맥폐새합병고동맥장단협착혹폐새적환자117례，남73례、녀44례，평균년령（64.3±0.6）세。기중57례행가동맥구낭확장﹢지가식입술，고동맥장단병변미주처리，작위A조；60례행가동맥급고동맥협착혹폐새병변혈관구낭확장﹢지가식입술，작위B조。분별우술전화술후당천검사과굉지수（ ABI）화파행거리，병우술후1、6、12、18、24개월시검측ABI、환지혈관통창솔、파행거리、보지솔。결과 A조술후당천ABI위（0.78±0.02），저우B조적（1.03±0.08）（P﹤0.05）；A조술후1、6、12、18개월시ABI저우B조，단술후24개월시고우B조〔（0.60±0.01）화（0.50±0.02），P﹤0.05〕。A조술후6、12、18、24개월시환지혈관통창솔균고우B조（ P﹤0.05）。A조술후당천파행거리위（521.5±19.7）m，단우B조적（674.7±22.6）m（P﹤0.05）；A조술후1、6、12、18개월시파행거리균단우B조（P﹤0.05），단술후24개월시A조파행거리장우B조〔（462.6±12.2） m화（401.4±19.1）m，P﹤0.05〕。수방24개월시A조소유환자지체균보류，B조유1례환자인병정진전행환지절지술（1조지체）。결론가동맥폐새합병고동맥장단혈관병변의수선강내개입치료；가동맥폐새합병유고동맥장단병변적환지，단순처리가동맥병변적원기효과우우가고동맥동시처리적원기효과。
Objective Toinvestigatetheclinicaleffectsofendovasculartreatmentoniliacarteryocclusion(IAO) combinedwithlongsegmentstenosisorocclusionofthefemoralartery(FA).Methods Atotalof117IAOpatientswithFA long segment stenosis or occlusion hospitalized in China-Japan Union Hospital of Jilin University from September 2011 to Novem-ber 2013〔73 males,44 females,meanly aged(64. 26 ± 0. 61)years〕were enrolled in this study. Fifty-seven patients had iliac artery( IA)balloon dilatation plus stent implantation but FA long segment lesions remained untreated( group A),60 had balloon dilatation of IA and FA stenosis or occlusion lesion plus stent implantation( group B ). The ankle -branchial index ( ABI),patency rate of affected limbs were determined before and after the operation,and BAI,patency rate of affected limbs, limpingdistance,limbsalvagerateweredeterminedinmonths1,6,12,18,24afteroperation.Results ABIwas(0.78± 0. 02)in group A on the operational day,lower than that of group B〔(1. 03 ± 0. 08),P﹤0. 05〕,lower than that of group B in months 1,6,12,18 after operation,but higher in months 24〔(0. 60 ± 0. 01) vs. (0. 50 ± 0. 02),respectively,P﹤0. 05〕. The patency rate of affected limbs was higher in group A than in group B in months 6,12,18,24(P﹤0. 05). The limping distance of group A was(521. 5 ± 19. 7)m,shorter than that of group B〔(674. 7 ± 22. 6) m,P﹤0. 05〕on the op-erational day,shorter in months 1,6,12,18 after operation(P﹤0. 05),but longer in months 24〔(462. 6 ±12. 2)m vs. (401. 4 ± 19. 1)m,P﹤0. 05〕. All patients retained their limbs in group A,1 had amputation due to disease progression in groupB(1limb).Conclusion IAOcombinedwithFAlongsegmentlesionshouldchooseintracavitaryinterventiontreatment first. The long-term effect of simple treatment on lesion affected limbs is superior to that of simultaneous treatment.