CAJ | 학술논문

目的：探讨介入治疗下肢动脉闭塞性疾病的中长期疗效。方法：选择下肢动脉闭塞性疾病患者260例，均经血管彩超及64排 CT 血管造影（CTA）确诊。其中髂动脉病变65条患肢，股腘动脉病变202条患肢，股腘动脉病变累及膝下三分支58条患肢，膝下小腿动脉分支闭塞43条患肢，每例患者均先球囊扩张治疗，如扩张不满意或出现夹层等酌情支架置入，术后随访12~72个月，分析介入治疗后的中长期疗效。结果：术中未出现血管破裂、穿孔等严重并发症；患者术后踝肱指数（ABI）较术前有明显升高，下肢动脉闭塞相关症状明显改善。随访期间患者再次出现下肢缺血症状142例，经数字减影血管造影（DSA）检查，内膜增生引起支架阻塞80例，非治疗部位血管出现狭窄或闭塞病变而出现下肢缺血症状30例，另外经皮血管成形术（PTA）治疗部位血管再狭窄12例，均经再次介入治疗后缺血症状改善。另有115例多次彩超复查示管腔通畅、血流良好；3例患者于术后16个月内死于脑卒中或心肌梗死。结论：介入治疗下肢动脉缺血性疾病操作创伤小，中长期疗效好，具有良好的临床应用价值。
목적：탐토개입치료하지동맥폐새성질병적중장기료효。방법：선택하지동맥폐새성질병환자260례，균경혈관채초급64배 CT 혈관조영（CTA）학진。기중가동맥병변65조환지，고객동맥병변202조환지，고객동맥병변루급슬하삼분지58조환지，슬하소퇴동맥분지폐새43조환지，매례환자균선구낭확장치료，여확장불만의혹출현협층등작정지가치입，술후수방12~72개월，분석개입치료후적중장기료효。결과：술중미출현혈관파렬、천공등엄중병발증；환자술후과굉지수（ABI）교술전유명현승고，하지동맥폐새상관증상명현개선。수방기간환자재차출현하지결혈증상142례，경수자감영혈관조영（DSA）검사，내막증생인기지가조새80례，비치료부위혈관출현협착혹폐새병변이출현하지결혈증상30례，령외경피혈관성형술（PTA）치료부위혈관재협착12례，균경재차개입치료후결혈증상개선。령유115례다차채초복사시관강통창、혈류량호；3례환자우술후16개월내사우뇌졸중혹심기경사。결론：개입치료하지동맥결혈성질병조작창상소，중장기료효호，구유량호적림상응용개치。
Objective:To evaluate the effect and clinical outcome of interventional therapy for lower limb ischemia. Meth-ods:Data of 260 patients with lower limb ischemia confirmed by vascular ultrasoundand and 64 - slice spiral computed tomo-graphy angiography(CTA). Among all patients,65 limbs were iliac arterial occlusion,and 202 case were iliac and femoral arte-rial,58 cases were femoral - popliteral and infra - popliteral artery,43 cases were infra - popliteral artery. All arteries under-went percutaneous transluminal angioplasty(PTA)and selected stent implantation fellowed in cases of dissection or residual stenosis after balloon angioplasty(179 patients,203 stents). All patients were followed up for 12 ~ 72 months. The middle and long - term efficacy after interventional therapy was analyzed. Results:NO severe complications such as angiorrhexis and perfo-ration were found during the interventional therapy. The symptoms of lower limb ischemia of all patients after interventional therapy were alleviated or disapp - eared. During the follow - up,3 patients died of acute myocardial infarction or strike at 16 months after interventional the - rapy,and 142 patients had the symptoms of lower limb ischemia again. DSA showed that stent occlusion caused by intimal hyperplasia occurred in 80 cases,and lower limb ischemia caused by vascular lesions at the site of non - therapy occurred in 30 cases,and the restenosis at the site of th - rombolysis and PTA therapy were 9 cases. These pa-tients got better and discharged from the hospital after PTA or stent implantation therapy. The other 115 cases had no recur-rence. The result of vascular ultrasound re - examinaxion showed smooth lumens and good blood flow. Conclusion:Int ervention-al therapy for lower limb ischemia has minimal invasion and good middle and long - term efficacy,so it has value of clinical ap-plication.