长段股腘动脉硬化闭塞症的腔内治疗  

Endovascular treatment of femoropopliteal atherosclerotic occlusive disease

作　　者：蔡志新[1] 李晓强[1] 尚斌[1] 钱爱民[1] 孟庆友[1] 

机构地区：[1]苏州大学附属第二医院血管外科,江苏苏州215004

出　　处：《中国血管外科杂志（电子版）》2013年第2期90-93,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的探讨血管腔内治疗技术在股腘动脉硬化闭塞症患者中的临床应用及其疗效。方法回顾性分析2010年7月～2012年8月我科收治的40例(47条肢体)股腘动脉硬化闭塞症(病变长度≥10cm)患者的临床资料。采用经皮腔内血管成形术及支架植入术,术后应用踝/肱指数(ABI)、Fontain分级、保肢率、一期通畅率等综合评估治疗效果。结果 38例(95%)手术成功。术后症状改善率95%,术后ABI为0.83±0.16,与术前(0.35±0.08)比较差异有统计学意义(P【0.01)。38例患者Fontaine分级均上升1级或以上。37例患者获得随访,随访时间12~24个月,1例术后2个月出现肢体缺血坏疽行截肢术,4例术后3~6个月症状复发,行第2次介入治疗,其余患者症状均无加重或复发。总体保肢率为95%,随访6个月时的一期通畅率为86.4%。结论股腘动脉硬化闭塞症腔内治疗是一种安全、有效的方法。熟练掌握腔内操作技术是提高技术成功率和维持近期通畅率的关键。Objective To explore the clinical application and efficacy of endovascular treatment of femoropopliteal atherosclerotic occlusive disease. Methods Forty cases (47 limbs)with femoropopliteal atherosclerotic occlusive disease(the length of occlusive lesions was more than 10.0 cm) were enrolled from July 2010 to August 2012. The ankle brachial index (ABI), limb salvage rate and primary patency rate were evaluated at 6 month after operation. Results The surgery success rate was 95%, the clinical ameliorated rate was 95%, the limb salvage rate was 95%, and the primary patency rate was 86.4%. There was significant difference in ABI before and after the therapy (0.35±0.08 vs 0.83±0.16, P < 0.01). Thirty-seven cases were followed-up for 12 to 24 months. One patient accepted amputation because limb ischemia and gangrene two months later, four patients needed the secondary interventional therapy because clinically relapsed after operation from 3 to 6 months. No recurrence occurred in the other patients. The overall limb salvage rate was 95%, primary patency rate was 86.4% at 6 months after operation. Conclusion Endovascular treatment of femoropopliteal atherosclerotic occlusive disease is effective and safe. Skillful endovascular technique is important for improving technical success rate and maintaining eary patency rate.

关 键 词：下肢动脉硬化闭塞症 股腘动脉 腔内治疗 治疗效果 

分 类 号：R654.3[医药卫生—外科学]