CAJ | 학술논문

目的探讨多节段髂股动脉闭塞症的治疗手段及临床疗效.方法选择2008年1月2011年6月间采用髂动脉支架植入联合股动脉内膜剥脱+补片成形术治疗的多节段髂股动脉硬化闭塞症36例患者,其中男性26例,女性10例；年龄49～ 87岁,平均65岁.对患者的随访结果进行回顾性分析,评价术前、后患者临床症状改善情况,采用Kaplan-Meier生存分析比较不同Fontaine分级患者间一期通畅率的差异,采用Cox回归分析筛选影响一期通畅率的独立因素等.结果本组患者手术均获成功,术后34例(94.4％)临床症状得到明显改善.平均随访24.2个月,一期通畅率为72.2％,辅助一期通畅率为83.3％,二期通畅率为94.4％.生存分析显示FontaineⅡ级患者一期通畅率明显高于Ⅲ、Ⅳ级患者(P =0.041、0.012).Cox回归分析未发现影响术后一期通畅率的独立因素.结论髂动脉支架植入联合股动脉内膜剥脱+补片成形术是治疗多节段髂股动脉闭塞症的有效方法,随访结果良好.
목적 탐토다절단가고동맥폐새증적치료수단급림상료효.방법 선택2008년1월2011년6월간채용가동맥지가식입연합고동맥내막박탈+보편성형술치료적다절단가고동맥경화폐새증36례환자,기중남성26례,녀성10례；년령49～ 87세,평균65세.대환자적수방결과진행회고성분석,평개술전、후환자림상증상개선정황,채용Kaplan-Meier생존분석비교불동Fontaine분급환자간일기통창솔적차이,채용Cox회귀분석사선영향일기통창솔적독립인소등.결과 본조환자수술균획성공,술후34례(94.4％)림상증상득도명현개선.평균수방24.2개월,일기통창솔위72.2％,보조일기통창솔위83.3％,이기통창솔위94.4％.생존분석현시FontaineⅡ급환자일기통창솔명현고우Ⅲ、Ⅳ급환자(P =0.041、0.012).Cox회귀분석미발현영향술후일기통창솔적독립인소.결론 가동맥지가식입연합고동맥내막박탈+보편성형술시치료다절단가고동맥폐새증적유효방법,수방결과량호.
Objective To evaluate the feasibility and efficacy of hybrid procedure for the treatment of multi-level iliac and common femoral occlusive disease.Methods From January 2008 to June 2011,36 lower limbs with sever iliac and common femoral occlusive diseases were treated by iliac artery stenting combined with open femoral endarterectomy.The mean age of the whole study population was 65 years (range 49 to 87 years) with a male predominance (26 males,72.2％).The early clinical results were determined by ankle brachial index and intermittent claudication distance.Patency analyses were performed using Kaplan-Meier life tables.Univariate and multivariate analysis were used to assess the influence of various risk factors on primary patency.Results All lower limbs underwent successful hybrid surgical and endovascular therapy.Clinical improvement was seen in 94.4％ of patients.The mean duration of follow-up was 24.2 months,overall,the primary patency rates,primary assisted patency rates and second patency rates were 72.2％,83.3％ and 94.4％ respectively.The primary patency rate for intermittent claudication was significantly higher than that for critical limb ischemia (P =0.041,0.012).Cox regression analysis did not reveal any independent predictor of primary patency.Conclusion Hybrid procedures provided an effective treatment management of multilevel iliac-femoral arterial occlusive disease.