中国微创外科杂志
中國微創外科雜誌
중국미창외과잡지
CHINESE JOURNAL OF MINIMALLY INVASIVE SURGERY
2015年
5期
434-437
,共4页
慢性闭塞性病变%踝下动脉%重症肢体缺血%足底弓技术%介入治疗
慢性閉塞性病變%踝下動脈%重癥肢體缺血%足底弓技術%介入治療
만성폐새성병변%과하동맥%중증지체결혈%족저궁기술%개입치료
Chronic total occlusion%Below-the-ankle%Critical limb ischemia%Pedal-plantar loop technique%Interventional treatment
目的：评价经足底弓腔内成形技术治疗踝下动脉闭塞性病变的可行性和疗效。方法2012年10月～2014年1月，对12例（14条患肢）踝下动脉闭塞性病变，采用足底弓腔内成形技术，顺行或逆行成功通过病变，对闭塞段行球囊扩张治疗。观察术后6个月的疼痛视觉模拟评分（VAS），足背或胫后动脉搏动评分，踝肱指数（ABI），患肢侧足背经皮氧分压（TcPO2）和溃疡愈合情况。结果9例（11条患肢）技术成功，除1例术后2个月死于脑血管意外外，其余8例（10条患肢）随访6个月，缺血症状无复发，VAS、ABI、TcPO2分别从术前的5．68±1．09，0．60±0．04，（25．71±5．25） mm Hg，改善至术后6个月的0．44±0．27，0．87±0．05，（35．90±5．28）mm Hg（P＜0．05），动脉搏动评分明显提高（P＝0．004）。溃疡均愈合，未出现相邻神经、血管损伤等严重并发症。1例技术不成功者因疼痛无缓解，感染未控制，行小腿截肢术。结论经足底弓腔内成形对治疗踝下动脉闭塞性病变具有良好前景，但长期效果有待进一步研究。
目的：評價經足底弓腔內成形技術治療踝下動脈閉塞性病變的可行性和療效。方法2012年10月～2014年1月，對12例（14條患肢）踝下動脈閉塞性病變，採用足底弓腔內成形技術，順行或逆行成功通過病變，對閉塞段行毬囊擴張治療。觀察術後6箇月的疼痛視覺模擬評分（VAS），足揹或脛後動脈搏動評分，踝肱指數（ABI），患肢側足揹經皮氧分壓（TcPO2）和潰瘍愈閤情況。結果9例（11條患肢）技術成功，除1例術後2箇月死于腦血管意外外，其餘8例（10條患肢）隨訪6箇月，缺血癥狀無複髮，VAS、ABI、TcPO2分彆從術前的5．68±1．09，0．60±0．04，（25．71±5．25） mm Hg，改善至術後6箇月的0．44±0．27，0．87±0．05，（35．90±5．28）mm Hg（P＜0．05），動脈搏動評分明顯提高（P＝0．004）。潰瘍均愈閤，未齣現相鄰神經、血管損傷等嚴重併髮癥。1例技術不成功者因疼痛無緩解，感染未控製，行小腿截肢術。結論經足底弓腔內成形對治療踝下動脈閉塞性病變具有良好前景，但長期效果有待進一步研究。
목적：평개경족저궁강내성형기술치료과하동맥폐새성병변적가행성화료효。방법2012년10월～2014년1월，대12례（14조환지）과하동맥폐새성병변，채용족저궁강내성형기술，순행혹역행성공통과병변，대폐새단행구낭확장치료。관찰술후6개월적동통시각모의평분（VAS），족배혹경후동맥박동평분，과굉지수（ABI），환지측족배경피양분압（TcPO2）화궤양유합정황。결과9례（11조환지）기술성공，제1례술후2개월사우뇌혈관의외외，기여8례（10조환지）수방6개월，결혈증상무복발，VAS、ABI、TcPO2분별종술전적5．68±1．09，0．60±0．04，（25．71±5．25） mm Hg，개선지술후6개월적0．44±0．27，0．87±0．05，（35．90±5．28）mm Hg（P＜0．05），동맥박동평분명현제고（P＝0．004）。궤양균유합，미출현상린신경、혈관손상등엄중병발증。1례기술불성공자인동통무완해，감염미공제，행소퇴절지술。결론경족저궁강내성형대치료과하동맥폐새성병변구유량호전경，단장기효과유대진일보연구。
Objective To assess the feasibility and efficiency of pedal-plantar loop technique in the treatment of below-the-ankle arterial occlusion . Methods A retrospective analysis was undertaken on 12 cases ( 14 legs ) of below-the-ankle arterial occlusion.The pedal-plantar loop angioplasty was performed in all the cases .Balloon angioplasty was performed after traversing through the arterial obstruction sites using antegrade or retrograde technique .After 6 months of the surgery , the results of visual analogue scale , dorsal or plantar arterial pulse volume scores , ankle brachial index , TcPO2 , and healing of the ulcer were compared to preoperative measures. Results Technical success was achieved in 9 cases (11 legs).During follow-up, 1 patient died of cerebrovascular events 2 months after the therapy .The other 8 cases (10 legs) were followed up for 6 months and no one had recurrent ischemic symptoms . The results of visual analogue scale , ankle brachial index, and TcPO2 before the surgery were (5.68 ±1.09) points, 0.60 ±0.04, and (25.71 ±5.25) mm Hg, which were improved to (0.44 ±0.27) points, 0.87 ±0.05, and (35.90 ±5.28) mm Hg (P<0.05).Dorsal or plantar arterial pulse volume scores were also enhanced markedly (P=0.004).Complete ulcer healing was observed in 8 limbs.No related complication was observed in other patients after the surgery .One technical unsuccessful patient who suffered infection and severe rest pain was given leg amputation . Conclusion Pedal-plantar loop technique is an effective therapy for below-the-ankle arterial occlusion while long term follow-up data need to be collected .
