中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
37期
3036-3040
,共5页
下肢%放射学,介入性%踝臂指数%经皮氧分压
下肢%放射學,介入性%踝臂指數%經皮氧分壓
하지%방사학,개입성%과비지수%경피양분압
Lower extremity%Radiology,interventional%Ankle braehial index%Transcutaneous oxygen pressure
目的 探讨彩色编码血流成像技术(Syngo iFlow)评估下肢动脉缺血性疾病腔内治疗前后患肢血流动力学改善情况的可行性和准确性及其与传统临床疗效评估方法的相关性.方法 回顾性分析2013年1月至2014年12月南京市第一医院介入科接受介入腔内治疗的21例下肢动脉硬化闭塞症严重下肢缺血患者的病历资料.男10例、女11例,年龄58～85(72 ±6)岁,股腘动脉TASCⅡB/C型病变.收集术前、术后完整的患肢循环状况的评估资料,包括临床症状体征(疼痛、冷感、跛行)评估、踝臂指数(ABI)、经皮氧分压(TcPO2)测量等,评价手术疗效.运用Syngo iFlow对术前术后患肢足踝部达峰时间(TTP)值进行测量,评价肢端血流动力学改善情况.采用t检验和Spearman等相关分析对资料进行统计学分析,评价Syngo iFlow和传统临床评估方法对腔内治疗前后患肢循环改善评估的相关性及一致性.结果 21例患者通过腔内治疗成功修复股腘动脉段重度狭窄及闭塞病变.术前传统临床方法评估:疼痛评分(0.48±0.68)、冷感评分(2.71±0.72)、跛行评分(2.86±0.85)、ABI(0.33±0.07)、TcPO2(26.83±3.41)mmHg(1 mmHg =0.133 kPa);术后1周评估:疼痛评分(2.57±0.93)、冷感评分(0.33±0.48)、跛行评分(0.90±0.54)、ABI(0.69 ±0.11)、TcPO2(53.75±3.60)mmHg,治疗前后差异有统计学意义(P＜0.05),显示患者下肢缺血症状均有显著改善.Syngo iFlow评估:术前足踝水平点测量TTP值(14.07±1.77)s,术后足踝水平点测量TTP值(10.43±2.05)s;术前足踝水平区域测量TTP值(18.75±2.72)s,术后足踝水平区域测量TTP值(15.38±2.78)s,治疗前后差异有统计学意义(P＜0.05),表明治疗后该区域血流灌注明显改善.Spearman相关性分析足踝部点测量△TTP和△ABI、△TcPO2之间呈正相关(r=0.65,0.73,均P＜0.05);区域测量△TTP和△ABI、△TcPO2之间呈正相关(r=0.60,0.60,均P＜0.05).结论 Syngo iFlow彩色编码血流成像技术可以用来实时量化分析下肢动脉阻塞性疾病血管成形术前后的血流动力学变化,其评估结果与传统临床疗效评估方法具有一致性.
目的 探討綵色編碼血流成像技術(Syngo iFlow)評估下肢動脈缺血性疾病腔內治療前後患肢血流動力學改善情況的可行性和準確性及其與傳統臨床療效評估方法的相關性.方法 迴顧性分析2013年1月至2014年12月南京市第一醫院介入科接受介入腔內治療的21例下肢動脈硬化閉塞癥嚴重下肢缺血患者的病歷資料.男10例、女11例,年齡58～85(72 ±6)歲,股腘動脈TASCⅡB/C型病變.收集術前、術後完整的患肢循環狀況的評估資料,包括臨床癥狀體徵(疼痛、冷感、跛行)評估、踝臂指數(ABI)、經皮氧分壓(TcPO2)測量等,評價手術療效.運用Syngo iFlow對術前術後患肢足踝部達峰時間(TTP)值進行測量,評價肢耑血流動力學改善情況.採用t檢驗和Spearman等相關分析對資料進行統計學分析,評價Syngo iFlow和傳統臨床評估方法對腔內治療前後患肢循環改善評估的相關性及一緻性.結果 21例患者通過腔內治療成功脩複股腘動脈段重度狹窄及閉塞病變.術前傳統臨床方法評估:疼痛評分(0.48±0.68)、冷感評分(2.71±0.72)、跛行評分(2.86±0.85)、ABI(0.33±0.07)、TcPO2(26.83±3.41)mmHg(1 mmHg =0.133 kPa);術後1週評估:疼痛評分(2.57±0.93)、冷感評分(0.33±0.48)、跛行評分(0.90±0.54)、ABI(0.69 ±0.11)、TcPO2(53.75±3.60)mmHg,治療前後差異有統計學意義(P＜0.05),顯示患者下肢缺血癥狀均有顯著改善.Syngo iFlow評估:術前足踝水平點測量TTP值(14.07±1.77)s,術後足踝水平點測量TTP值(10.43±2.05)s;術前足踝水平區域測量TTP值(18.75±2.72)s,術後足踝水平區域測量TTP值(15.38±2.78)s,治療前後差異有統計學意義(P＜0.05),錶明治療後該區域血流灌註明顯改善.Spearman相關性分析足踝部點測量△TTP和△ABI、△TcPO2之間呈正相關(r=0.65,0.73,均P＜0.05);區域測量△TTP和△ABI、△TcPO2之間呈正相關(r=0.60,0.60,均P＜0.05).結論 Syngo iFlow綵色編碼血流成像技術可以用來實時量化分析下肢動脈阻塞性疾病血管成形術前後的血流動力學變化,其評估結果與傳統臨床療效評估方法具有一緻性.
목적 탐토채색편마혈류성상기술(Syngo iFlow)평고하지동맥결혈성질병강내치료전후환지혈류동역학개선정황적가행성화준학성급기여전통림상료효평고방법적상관성.방법 회고성분석2013년1월지2014년12월남경시제일의원개입과접수개입강내치료적21례하지동맥경화폐새증엄중하지결혈환자적병력자료.남10례、녀11례,년령58～85(72 ±6)세,고객동맥TASCⅡB/C형병변.수집술전、술후완정적환지순배상황적평고자료,포괄림상증상체정(동통、랭감、파행)평고、과비지수(ABI)、경피양분압(TcPO2)측량등,평개수술료효.운용Syngo iFlow대술전술후환지족과부체봉시간(TTP)치진행측량,평개지단혈류동역학개선정황.채용t검험화Spearman등상관분석대자료진행통계학분석,평개Syngo iFlow화전통림상평고방법대강내치료전후환지순배개선평고적상관성급일치성.결과 21례환자통과강내치료성공수복고객동맥단중도협착급폐새병변.술전전통림상방법평고:동통평분(0.48±0.68)、랭감평분(2.71±0.72)、파행평분(2.86±0.85)、ABI(0.33±0.07)、TcPO2(26.83±3.41)mmHg(1 mmHg =0.133 kPa);술후1주평고:동통평분(2.57±0.93)、랭감평분(0.33±0.48)、파행평분(0.90±0.54)、ABI(0.69 ±0.11)、TcPO2(53.75±3.60)mmHg,치료전후차이유통계학의의(P＜0.05),현시환자하지결혈증상균유현저개선.Syngo iFlow평고:술전족과수평점측량TTP치(14.07±1.77)s,술후족과수평점측량TTP치(10.43±2.05)s;술전족과수평구역측량TTP치(18.75±2.72)s,술후족과수평구역측량TTP치(15.38±2.78)s,치료전후차이유통계학의의(P＜0.05),표명치료후해구역혈류관주명현개선.Spearman상관성분석족과부점측량△TTP화△ABI、△TcPO2지간정정상관(r=0.65,0.73,균P＜0.05);구역측량△TTP화△ABI、△TcPO2지간정정상관(r=0.60,0.60,균P＜0.05).결론 Syngo iFlow채색편마혈류성상기술가이용래실시양화분석하지동맥조새성질병혈관성형술전후적혈류동역학변화,기평고결과여전통림상료효평고방법구유일치성.
Objective To investigate the feasibility of parametric color coding of digital subtraction angiography(Syngo iFlow)for hemodynamics assessment in patients with critical limb ischemia in pre-and post-endovascular therapy.To explore the correlation between Syngo iFlow and the conventional techniques.Methods from January 2013 to December 2014,Clinical data of 21 patients with TASC Ⅱ type B and type C femoropopliteal arteriosclerotic occlusive disease who were treated by percutaneous transluminal angioplasty and/or primary stent implantation in Nanjing first hospital were analyzed retrospectively.Of these patients there were 10 males and 11 females with an average age of (72 ±6) years (range from 58-85 years).The treatment efficacy was assessed by the variation of a series of clinical symptoms indexes (such as pain score,cold sensation score and intermittent claudication score),ankle braehial index (ABI) and transcutaneous oxygen pressure (TcPO2).Angiography was performed with the same protocol before and after treatment and parametric color coding of digital subtraction angiography was created by Syngo iFlow software on a dedicated workstation.The time to peak (TTP) of artery and tissue perfusion selected at the same regions of foot and ankle were measured and analyzed to evaluate the improvement of microcirculation and hemodynamics of the ischemic limb.The correlations between Syngo iFlow and the traditional clinical evaluation methods were explored using the Spearman rank correlation test.Results All patients (21 limbs) underwent successful endovaseular therapy.The mean pain score,cold sensation score,intermittent claudication score,ABI and TcPO2 before treatment were(0.48 ± 0.68),(2.71 ± 0.72),(2.86 ± 0.85),ABI (0.33 ± 0.07),TcPO2 (26.83 ± 3.41) mmHg.While 1 week after treatment all above indicators were (2.57 ± 0.93),(0.33 ± 0.48),(0.90 ± 0.54),(0.69 ± 0.11),TcPO2 (53.75 ± 3.60) mmHg respectively.There were significant statistical differences between pre-and post-treatment(P ＜ 0.05).The pre-and post-operative TTP of artery and tissue perfusion were (14.07 ± 1.77) vs (10.43 ±2.05)s,(18.75 ±2.72) vs (15.38 ±2.78)s.For assessment of hemodynamic changes during and after treatment,parametric color coding of digital subtraction angiography(Syngo iFlow) was assumed to show the limb blood flow and perfusion were improved and the differences were statistically significant.The Spearman rank correlation test showed the TTP of artery was positively correlated with ABI,TcPO2 (r =0.65,0.73,P ＜ 0.05),the TTP of tissue perfusion was also positively correlated with ABI,TcPO2(r =0.60,0.60,P ＜0.05).Conclusion Parametric color coding of digital subtraction angiography(Syngo iFlow) is a real-time,sensitive and quantitative tool that might provide additional support in the hemodynamics evaluation of endovascular treatment for patients with lower extremity peripheral arterial occlusion disease.
