CAJ | 학술논문

目的评价不同剂量短时重组人组织型纤溶酶原激活剂(rt-PA)导管接触性溶栓联合血管腔内介入治疗对急性和亚急性下肢缺血患者的治疗效果.方法将北京朝阳医院血管外科自2006年11月至2011年12月诊断为急性或亚急性下肢缺血的84例患者随机分成两组,分别给予总剂量20 mg(A组)和10 mg(B组)的rt-PA进行导管接触溶栓,根据再次造影结果对病变明显部位进行腔内介入治疗.术后随访,对疗效、并发症及术后30 d、6个月和12个月患肢保全情况进行评价.统计学分析采用SPSS 16.0软件,使用t检验和x2检验.结果两组患者一般情况和病变情况差异无统计学意义(P＞0.05),操作成功率和临床成功率均为100％,rt-PA剂量对溶栓效果无影响(P＞0.05),PTA和支架的比例差异无统计学意义(P＞0.05).两组并发症发生率及随访30 d、6个月和12个月的截肢率差异无统计学意义(P＞0.05).结论短时导管接触溶栓联合血管腔内介入治疗对急性和亚急性下肢缺血患者的治疗效果好,且rt-PA剂量对溶栓效果无影响,值得临床推广应用.
목적 평개불동제량단시중조인조직형섬용매원격활제(rt-PA)도관접촉성용전연합혈관강내개입치료대급성화아급성하지결혈환자적치료효과.방법 장북경조양의원혈관외과자2006년11월지2011년12월진단위급성혹아급성하지결혈적84례환자수궤분성량조,분별급여총제량20 mg(A조)화10 mg(B조)적rt-PA진행도관접촉용전,근거재차조영결과대병변명현부위진행강내개입치료.술후수방,대료효、병발증급술후30 d、6개월화12개월환지보전정황진행평개.통계학분석채용SPSS 16.0연건,사용t검험화x2검험.결과 량조환자일반정황화병변정황차이무통계학의의(P＞0.05),조작성공솔화림상성공솔균위100％,rt-PA제량대용전효과무영향(P＞0.05),PTA화지가적비례차이무통계학의의(P＞0.05).량조병발증발생솔급수방30 d、6개월화12개월적절지솔차이무통계학의의(P＞0.05).결론 단시도관접촉용전연합혈관강내개입치료대급성화아급성하지결혈환자적치료효과호,차rt-PA제량대용전효과무영향,치득림상추엄응용.
Objectives To evaluate the performance effect of short-term catheter-directed thrombolysis with different dosage of rt-PA allied with endovascular interventional therapy for patients with acute lower limb ischemia.Methods To separate 84 consecutive patients suffered from acute lower limb ischemia into two groups at random,then adopt catheter-directed thrombolysis for each group of patients injected 20 mg (Group A) or 10 mg (Group B) rt-PA into the occlusive lesion correspondingly,and subsequently perform endovascular intervention on significant underlying lesions on the base of angiography results.Adopt statistical methods to assess treatment effectiveness,rates of complication and amputation rates within 30 days,6 months or 12 months.The statistic analysis was performed under SPSS 16.0 format,and adopts t test and x2 test.Results There was no statistical difference on patient characteristics and lesions between both groups (P ＞ 0.05).Procedural success rates as well clinical success rates were all 100％.Not incur any diversity on thrombolysis effectiveness between both groups injected different dosage of rt-PA (P ＞ 0.05).Not found major differences on ratios of PTA or implant stent between both groups (P ＞ 0.05).During the follow-up period of 30-day,6-,12-months,there were no statistical differences on the amputation-free survival rates and complication rates between both groups.Conclusions Whereas short-term catheter-directed thrombolysis combined with endovascular interventional therapy won good operation effectiveness on patients with acute lower limb ischemia,moreover the dosage of rt-PA did not impact on thrombolysis,it is worthy to be applied in the clinical practice.