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
576-579
,共4页
张童%庄百溪%石波%杨淼%于春利%马鲁波
張童%莊百溪%石波%楊淼%于春利%馬魯波
장동%장백계%석파%양묘%우춘리%마로파
糖尿病血管病变%血管成形术%缺血%四肢救助%存活率
糖尿病血管病變%血管成形術%缺血%四肢救助%存活率
당뇨병혈관병변%혈관성형술%결혈%사지구조%존활솔
Diabetic angiopathies%Angioplasty%Ischemia%Limb salvage%Survival rate
目的 总结分析糖尿病膝下动脉病变患者经腔内治疗的中远期疗效.方法 回顾性分析2005年8月至2012年5月期间连续收治的Wagner 1 ～4级糖尿病膝下动脉病变患者762例(797条患肢)的临床资料,统计经血管腔内治疗的技术成功率、并发症率,随访期间观察踝肱比变化、伤口愈合率、保肢率及生存率.结果 762例(797条患肢)共进行857次血管腔内治疗,即刻技术成功805次(93.93％).围手术期并发症:入路相关性血肿或假性动脉瘤33例(4.33％);迷走神经反射20例(2.62％);膝下动脉破裂38例(4.99％);血流限制性夹层75例(9.84％);动脉栓塞23例(3.02％);蓝趾征4例(0.52％).术后平均ABI明显改善[(0.33 ±0.20)升至(0.68±0.17),P＜0.005)].共722例患者(751条患肢)随访12个月以上,平均(35±23)个月,期间3个月内伤口愈合率达72.28％,12个月保肢率为85.62％,生存率为95.01％.结论 腔内治疗糖尿病膝下动脉病变即刻技术成功率高、并发症低,中远期疗效确切,目前可作为其首选治疗方案.
目的 總結分析糖尿病膝下動脈病變患者經腔內治療的中遠期療效.方法 迴顧性分析2005年8月至2012年5月期間連續收治的Wagner 1 ～4級糖尿病膝下動脈病變患者762例(797條患肢)的臨床資料,統計經血管腔內治療的技術成功率、併髮癥率,隨訪期間觀察踝肱比變化、傷口愈閤率、保肢率及生存率.結果 762例(797條患肢)共進行857次血管腔內治療,即刻技術成功805次(93.93％).圍手術期併髮癥:入路相關性血腫或假性動脈瘤33例(4.33％);迷走神經反射20例(2.62％);膝下動脈破裂38例(4.99％);血流限製性夾層75例(9.84％);動脈栓塞23例(3.02％);藍趾徵4例(0.52％).術後平均ABI明顯改善[(0.33 ±0.20)升至(0.68±0.17),P＜0.005)].共722例患者(751條患肢)隨訪12箇月以上,平均(35±23)箇月,期間3箇月內傷口愈閤率達72.28％,12箇月保肢率為85.62％,生存率為95.01％.結論 腔內治療糖尿病膝下動脈病變即刻技術成功率高、併髮癥低,中遠期療效確切,目前可作為其首選治療方案.
목적 총결분석당뇨병슬하동맥병변환자경강내치료적중원기료효.방법 회고성분석2005년8월지2012년5월기간련속수치적Wagner 1 ～4급당뇨병슬하동맥병변환자762례(797조환지)적림상자료,통계경혈관강내치료적기술성공솔、병발증솔,수방기간관찰과굉비변화、상구유합솔、보지솔급생존솔.결과 762례(797조환지)공진행857차혈관강내치료,즉각기술성공805차(93.93％).위수술기병발증:입로상관성혈종혹가성동맥류33례(4.33％);미주신경반사20례(2.62％);슬하동맥파렬38례(4.99％);혈류한제성협층75례(9.84％);동맥전새23례(3.02％);람지정4례(0.52％).술후평균ABI명현개선[(0.33 ±0.20)승지(0.68±0.17),P＜0.005)].공722례환자(751조환지)수방12개월이상,평균(35±23)개월,기간3개월내상구유합솔체72.28％,12개월보지솔위85.62％,생존솔위95.01％.결론 강내치료당뇨병슬하동맥병변즉각기술성공솔고、병발증저,중원기료효학절,목전가작위기수선치료방안.
Objective To analyze the mid and long term results of endovascular procedures for diabetic below-the-knee lesions.Methods We retrospectively analyzed data of 762 patients (797 limbs in Wagner Grade 1 to 4) who suffered ischemic symptoms of diabetic below-the-knee lesions,admitted for endovascular procedures from Aug 2005 to May 2012.Technical success rate and complications,anklebrachial index,wound healing,limb salvage and survival were evaluated.Results 762 patients (797 limbs) underwent 857 endovascular procedures with immediate technical success in 805 times (success rate 93.93％).30 day complications included 33 cases (4.33％) of hematoma or pseudoaneurysm related to access site,20 cases (2.62％) of vasovagal reflex,38 cases (4.99％) of belowthe-knee arteriorrhexis,75 cases (9.84％) of inflow-limited dissection,23 cases (3.02％) of arterial embolism,4 cases (0.52％) of blue-toe sign.Postoperative mean ABI was improved significantly,from 0.33 ± 0.20 to 0.68 ± 0.17,P ＜ 0.005.722 patients (751 limbs) were followed up for more than 12 months (35 ± 23 months),wound healing rate within 3 months was 72.28％,limb salvage rate after 12 months was 85.62％,survival rate was 95.01％.Conclusions Immediate technical success rate of endovascular procedures for diabetic below-the-knee lesions is high,complications rate is low,medium and long term efficacy is satisfactory.
