南方医科大学学报
南方醫科大學學報
남방의과대학학보
JOURNAL OF SOUTHERN MEDICAL UNIVERSITY
2014年
11期
1672-1675
,共4页
邵泽锋%王自正%顾建平%何旭%楼文胜%陈亮%陈国平%宋进华%王国品%WANG Guopin
邵澤鋒%王自正%顧建平%何旭%樓文勝%陳亮%陳國平%宋進華%王國品%WANG Guopin
소택봉%왕자정%고건평%하욱%루문성%진량%진국평%송진화%왕국품%WANG Guopin
动脉硬化闭塞性疾病%内膜下血管成形术%球囊%介入放射学
動脈硬化閉塞性疾病%內膜下血管成形術%毬囊%介入放射學
동맥경화폐새성질병%내막하혈관성형술%구낭%개입방사학
arterial occlusive disease%subintimal angioplasty technique%balloon%interventional radiology
目的：探讨逆行穿刺内膜下成形术（SlA）对膝下动脉长段硬化闭塞症的治疗效果和临床应用价值。方法回顾性分析我院50例膝下动脉长段硬化闭塞症的临床资料，其中25例采用顺行SlA治疗为对照组，另25例在顺行SlA失败后采用逆行穿刺SIA对狭窄或闭塞性病变进行长球囊扩张为实验组，对手术前后两组患者的踝肱指数（ABI）、皮温进行组间及组内的比较分析。结果50例技术即时成功率均为100%，术后肢体缺血症状得到明显改善，无严重并发症发生。实验组患者ABI由术前的0.31±0.12增至术后24 h、1周、3月、6月及12月的0.47±0.09、0.56±0.06、0.63±0.07、0.58±0.06、0.49±0.03；皮温（T，℃）由术前的28.13±2.45增至术后24 h、1周、3月、6月及12月的33.87±1.24、34.16±0.44、34.19±0.25、32.45±0.25、31.05±0.21，术后24 h、1周、3月、6月及12月ABI与T分别与术前比较差异有统计学意义（P<0.05）。与对照组患者手术前后ABI、T改善率及血流通畅率比较差异无统计学意义（P>0.05）。结论逆行穿刺SIA治疗膝下动脉硬化闭塞症的临床成功率高、并发症少，是顺行SIA失败后治疗膝下动脉长段硬化闭塞症安全有效的方法。
目的：探討逆行穿刺內膜下成形術（SlA）對膝下動脈長段硬化閉塞癥的治療效果和臨床應用價值。方法迴顧性分析我院50例膝下動脈長段硬化閉塞癥的臨床資料，其中25例採用順行SlA治療為對照組，另25例在順行SlA失敗後採用逆行穿刺SIA對狹窄或閉塞性病變進行長毬囊擴張為實驗組，對手術前後兩組患者的踝肱指數（ABI）、皮溫進行組間及組內的比較分析。結果50例技術即時成功率均為100%，術後肢體缺血癥狀得到明顯改善，無嚴重併髮癥髮生。實驗組患者ABI由術前的0.31±0.12增至術後24 h、1週、3月、6月及12月的0.47±0.09、0.56±0.06、0.63±0.07、0.58±0.06、0.49±0.03；皮溫（T，℃）由術前的28.13±2.45增至術後24 h、1週、3月、6月及12月的33.87±1.24、34.16±0.44、34.19±0.25、32.45±0.25、31.05±0.21，術後24 h、1週、3月、6月及12月ABI與T分彆與術前比較差異有統計學意義（P<0.05）。與對照組患者手術前後ABI、T改善率及血流通暢率比較差異無統計學意義（P>0.05）。結論逆行穿刺SIA治療膝下動脈硬化閉塞癥的臨床成功率高、併髮癥少，是順行SIA失敗後治療膝下動脈長段硬化閉塞癥安全有效的方法。
목적：탐토역행천자내막하성형술（SlA）대슬하동맥장단경화폐새증적치료효과화림상응용개치。방법회고성분석아원50례슬하동맥장단경화폐새증적림상자료，기중25례채용순행SlA치료위대조조，령25례재순행SlA실패후채용역행천자SIA대협착혹폐새성병변진행장구낭확장위실험조，대수술전후량조환자적과굉지수（ABI）、피온진행조간급조내적비교분석。결과50례기술즉시성공솔균위100%，술후지체결혈증상득도명현개선，무엄중병발증발생。실험조환자ABI유술전적0.31±0.12증지술후24 h、1주、3월、6월급12월적0.47±0.09、0.56±0.06、0.63±0.07、0.58±0.06、0.49±0.03；피온（T，℃）유술전적28.13±2.45증지술후24 h、1주、3월、6월급12월적33.87±1.24、34.16±0.44、34.19±0.25、32.45±0.25、31.05±0.21，술후24 h、1주、3월、6월급12월ABI여T분별여술전비교차이유통계학의의（P<0.05）。여대조조환자수술전후ABI、T개선솔급혈류통창솔비교차이무통계학의의（P>0.05）。결론역행천자SIA치료슬하동맥경화폐새증적림상성공솔고、병발증소，시순행SIA실패후치료슬하동맥장단경화폐새증안전유효적방법。
Objective To assess the clinical efficacy of retrograde puncture subintimal angioplasty (SIA) for treatment of occlusive diseases in the long segment of the infrapopliteal artery. Methods The clinical data of 50 patients with occlusive diseases in the long segment of the infrapopliteal artery were retrospectively analyzed. The patients were divided into control group (n=25) and study group (n=25) and received antegrade SIA and retrograde puncture SIA with long balloon after the failed antegrade SIA, respectively. The ankle brachial index (ABI) and the temperature of the infrapopliteal skin before and after the operation were compared between the two groups. Results The technical success rate was 100% in the 50 patients, who showed obviously improved ischemic symptoms without serious complications. The ABI of the study group increased from 0.31±0.12 before the treatment to 0.47±0.09 at 24 h, 0.56±0.06 at 1week, 0.63±0.07 at 3 months, 0.58±0.06 at 6 months, and 0.49 ± 0.03 at 12 months after the treatment, and the skin temperature increased from 28.13 ± 2.45 before the operation to 33.87 ± 1.24, 34.16 ± 0.44, 34.19 ± 0.25, 32.45 ± 0.25, and 31.05 ± 0.21 at the corresponding time points after the treatment, respectively, showing significant improvements after the operation (P<0.05). ABI, skin temperature and the patency rate were similar between the two groups at each of the postoperative time points (P>0.05). Conclusion Retrograde puncture SIA is safe and effective for treatment of arteriosclerosis obliterans in the infrapopliteal arteries with a high clinical success rate and a low complication rate after the failure of antegrade SIA.
