中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2014年
8期
571-575
,共5页
李振江%袁良喜%景在平%包俊敏
李振江%袁良喜%景在平%包俊敏
리진강%원량희%경재평%포준민
动脉闭塞性疾病%血管成形术%Angiosome概念
動脈閉塞性疾病%血管成形術%Angiosome概唸
동맥폐새성질병%혈관성형술%Angiosome개념
Arterial occlusive diseases%Angioplasty%Angiosome
目的 评价血管区域(Angiosome)概念在下肢重症缺血(critical limb ischemia,CLI)腔内治疗中的临床价值.方法 回顾性分析2011年7月至2013年10月在Angiosome概念指导下行膝下动脉血管成形术的62例(62侧肢体)CLI(Rutherford 5级/6级)患者的临床资料.根据是否开通缺血血管区域源血管分为直接组35例(开通缺血血管区域源血管)和间接组27例(开通相邻血管),对2组患者的踝-肱指数(ankle-brachial index,ABI)、溃疡愈合情况及无截肢率等临床疗效指标进行对比分析.结果 2组患者术前ABI(直接组0.16 ±0.26,间接组0.15 ±0.28,P=0.885)和术后ABI(直接组0.82 ±0.26,间接组0.81 ±0.24,P=0.877)差异无统计学意义;术后1年间的溃疡愈合率直接组(91％)明显高于间接组(74％),差异有统计学意义(P =0.027),2组患者的溃疡愈合时间直接组(162 ±49)d,间接组(160 ±46)d,差异无统计学意义(P=0.950);1年无截肢率直接组(84％±3％)明显高于间接组(76％±4％),差异有统计学意义(P=0.025),2年无截肢率直接组(79％±4％)明显高于间接组(72％±4％),差异有统计学意义(P=0.031). 结论 应用Angiosome 概念指导腔内治疗有助于提高CLI患者的临床疗效,促进溃疡创面愈合和提高无截肢率.
目的 評價血管區域(Angiosome)概唸在下肢重癥缺血(critical limb ischemia,CLI)腔內治療中的臨床價值.方法 迴顧性分析2011年7月至2013年10月在Angiosome概唸指導下行膝下動脈血管成形術的62例(62側肢體)CLI(Rutherford 5級/6級)患者的臨床資料.根據是否開通缺血血管區域源血管分為直接組35例(開通缺血血管區域源血管)和間接組27例(開通相鄰血管),對2組患者的踝-肱指數(ankle-brachial index,ABI)、潰瘍愈閤情況及無截肢率等臨床療效指標進行對比分析.結果 2組患者術前ABI(直接組0.16 ±0.26,間接組0.15 ±0.28,P=0.885)和術後ABI(直接組0.82 ±0.26,間接組0.81 ±0.24,P=0.877)差異無統計學意義;術後1年間的潰瘍愈閤率直接組(91％)明顯高于間接組(74％),差異有統計學意義(P =0.027),2組患者的潰瘍愈閤時間直接組(162 ±49)d,間接組(160 ±46)d,差異無統計學意義(P=0.950);1年無截肢率直接組(84％±3％)明顯高于間接組(76％±4％),差異有統計學意義(P=0.025),2年無截肢率直接組(79％±4％)明顯高于間接組(72％±4％),差異有統計學意義(P=0.031). 結論 應用Angiosome 概唸指導腔內治療有助于提高CLI患者的臨床療效,促進潰瘍創麵愈閤和提高無截肢率.
목적 평개혈관구역(Angiosome)개념재하지중증결혈(critical limb ischemia,CLI)강내치료중적림상개치.방법 회고성분석2011년7월지2013년10월재Angiosome개념지도하행슬하동맥혈관성형술적62례(62측지체)CLI(Rutherford 5급/6급)환자적림상자료.근거시부개통결혈혈관구역원혈관분위직접조35례(개통결혈혈관구역원혈관)화간접조27례(개통상린혈관),대2조환자적과-굉지수(ankle-brachial index,ABI)、궤양유합정황급무절지솔등림상료효지표진행대비분석.결과 2조환자술전ABI(직접조0.16 ±0.26,간접조0.15 ±0.28,P=0.885)화술후ABI(직접조0.82 ±0.26,간접조0.81 ±0.24,P=0.877)차이무통계학의의;술후1년간적궤양유합솔직접조(91％)명현고우간접조(74％),차이유통계학의의(P =0.027),2조환자적궤양유합시간직접조(162 ±49)d,간접조(160 ±46)d,차이무통계학의의(P=0.950);1년무절지솔직접조(84％±3％)명현고우간접조(76％±4％),차이유통계학의의(P=0.025),2년무절지솔직접조(79％±4％)명현고우간접조(72％±4％),차이유통계학의의(P=0.031). 결론 응용Angiosome 개념지도강내치료유조우제고CLI환자적림상료효,촉진궤양창면유합화제고무절지솔.
Objective To evaluate the clinical value of endovascular therapy based on Angiosome concept in critical limb ischemia (CLI) patients.Methods A retrospective study was undertaken in 62 patients (62 limbs) diagnosed as critical limb ischemia (Rutherford class 5/6) and received percutaneous transluminal angioplasty from July 2011 to October 2013.Patients were divided into direct (35 patients) and indirect (27 patients) groups depending on whether feeding artery flow to the site of ulcer was successfully achieved or not based on the angiosome concept,and the between-group clinic outcomes including preoperative and postoperative ankle-brachial index (ABI),ulcer healing,and the rates of freedom from amputation were compared and analyzed.Results There were no significant difference between two groups for ABI pre-operatively (0.16 ±0.26 vs.0.15 ±0.28; P =0.885) and post-operatively (0.82 ± 0.26 vs.0.81 ±0.24; P =0.877).During follow-up,the healing rate of ischemia ulcer in patients without amputation at 1 year (91％ vs.74％ ; P =0.027) were significantly higher in the direct group than in the indirect group.There was no difference between two groups for healing time (162 ±49) d vs.(160 ±46) d; P =0.950).The rates of freedom from amputation at 1 year (84％ ±3％ vs.76％ ±4％ ; P =0.025) and 2 years (79％ ±4％ vs.72％ ±4％ ; P =0.031) were significantly higher in the direct group than in the indirect group.Conclusions Endovascular therapy based on Angiosome concept in CLI patient is an effective procedure with satisfactory clinic outcomes,contributing to healing of ischemia ulcer and increase amputation-free rate.
