CAJ | 학술논문

目的探讨近十年下肢动脉硬化闭塞症外科治疗方法及预后的变化.方法回顾性分析2002年1月至2011年12月首都医科大学宣武医院血管外科收治并获得随访的下肢动脉硬化闭塞症患者的临床资料,对比分析2002至2006年和2007至2011年接受手术治疗患者的一般资料、危险因素、病情程度、病变解剖特点及治疗方法,按前后两个时间段分为2002-2006年组和2007-2011年组,观察两个时间段手术治疗方法的变化及对预后的影响,组间比较采用x2检验、Fisher确切概率法和t检验.结果十年间共收治患者2 051例,其中1 613例(1 845条肢体)获得随访.2002至2006年组接受传统手术治疗170例(47.49％),介入治疗72例(20.11％),干细胞治疗116例(32.40％),基因药物治疗0例;2007至2011年组接受传统手术治疗275例(18.49％),介入治疗1 022例(68.73％),干细胞治疗123例(8.27％),基因药物治疗67例(4.51％).前组的保肢率明显低于后组(87.15％比93.41％,x2=15.71,P=0.000),但两组的生存率差异无统计学意义(84.67％比84.31％,x2=0.02,P=0.880).结论近年来随着介入新器材的不断面世和基因药物临床研究的出现,下肢动脉硬化闭塞症患者接受动脉腔内介入治疗的比例逐渐增加,患者的保肢率提高.
목적 탐토근십년하지동맥경화폐새증외과치료방법급예후적변화.방법 회고성분석2002년1월지2011년12월수도의과대학선무의원혈관외과수치병획득수방적하지동맥경화폐새증환자적림상자료,대비분석2002지2006년화2007지2011년접수수술치료환자적일반자료、위험인소、병정정도、병변해부특점급치료방법,안전후량개시간단분위2002-2006년조화2007-2011년조,관찰량개시간단수술치료방법적변화급대예후적영향,조간비교채용x2검험、Fisher학절개솔법화t검험.결과 십년간공수치환자2 051례,기중1 613례(1 845조지체)획득수방.2002지2006년조접수전통수술치료170례(47.49％),개입치료72례(20.11％),간세포치료116례(32.40％),기인약물치료0례;2007지2011년조접수전통수술치료275례(18.49％),개입치료1 022례(68.73％),간세포치료123례(8.27％),기인약물치료67례(4.51％).전조적보지솔명현저우후조(87.15％비93.41％,x2=15.71,P=0.000),단량조적생존솔차이무통계학의의(84.67％비84.31％,x2=0.02,P=0.880).결론 근년래수착개입신기재적불단면세화기인약물림상연구적출현,하지동맥경화폐새증환자접수동맥강내개입치료적비례축점증가,환자적보지솔제고.
Objective To analyze the trends in treatments of lower extremity peripheral arterial disease and their prognosis in the recent 10 years.Methods Clinical data of inpatients with lower extremity peripheral arterial disease who received surgical treatments in Xuanwu Hospital from January 2002 to December 2011 were analyzed retrospectively.Patients were stratified into two groups (group 1:from 2002 to 2006,group 2:from 2007 to 2011).The demographics,risk factors,clinical presentation,lesion anatomy,therapies,limb salvage and survival were observed.x2 test,Fisher exact test,and t test were used to compare the data between the two groups.Results From 2002 to 2006,170 limbs (47.49％) underwent conventional bypass surgery,72 limbs (20.11％) underwent endovascular interventions and the rest 116 limbs (32.40％) received stem cell treatment.While from 2007 to 2011,the percentages were 18.49％,68.73％,8.27％,respectively.Furthermore,gene-based drug appeared,67 limbs (4.51％) underwent the new treatment.Former group had decreased limb salvage rates compared with latter group (87.15％ vs.93.41％,x2 =15.71,P =0.000).However,survival rates did not differ from the two groups (84.67％ vs.84.31％,x2 =0.02,P =0.880).Conclusion With the appearance of new medical instruments and operating methods,the percentage of the patients with lower extremity peripheral arterial disease receive endovascular interventions increases,with a improved limb salvage rates.