42例介入治疗髂动脉和股动脉闭塞性病变的临床疗效观察  

Cfinical use of interventionai therapy for occlusive lesion in iliac arteries and femoral arteries of 42 cases

作　　者：肖亮[1] 徐克[1] 张曦彤[1] 李红[1] 

机构地区：[1]中国医科大学附属第一医院放射科,沈阳110001

出　　处：《中华放射学杂志》2008年第8期840-843,共4页Chinese Journal of Radiology

基　　金：国家“十一五”科技支撑计划资助项目（2007BAI05B04）

摘　　要：目的探讨介入治疗对于髂、股动脉闭塞性病变的临床疗效。方法回顾性分析42例髂动脉和（或）股动脉闭塞患者的临床资料。42例患者分别采用经导管溶栓、导丝开通、经皮血管腔内成形术（PTA）、支架置入术等方法进行介入治疗，随访2年，对介入治疗前后Rutherford评分进行双尾法配对Wilcoxon检验，踝肱指数（ABI）进行双尾法配对t检验。结果治疗中，首次开通成功率97．6％（41／42），2次开通成功率100％（42／42）。溶栓治疗26例，机械开通31例，PTA33例，支架置入31例（60枚）。术中未出现血管破裂、穿孔等严重并发症。术后所有患者下肢缺血症状明显减轻或消失。Rutherford评分由治疗前中位数4．0分降至治疗后中位数1．0分，差异具有统计学意义（Z=-5．887，p〈0．01）；踝肱指数由治疗前0．34±0．14增加至0．65±0．10，差异也具有统计学意义（t=25．924，P〈0．01）。术后1年初次开通率92．8％（39／42），2次开通率100．0％（42／42）；术后2年初次开通率71．4％（30／42），2次开通率97．6％（41／42）。结论介入治疗髂、股动脉闭塞性病变，创伤小、疗效好，具有良好的临床应用价值。Objective To evaluate the efficacy of interventional therapy of occlusive lesion in iliacofemoral arteries. Methods During Feb 2001 to Feb 2006, 42 patients （30 male and 12 female） with arterial occlusive lesions in iliac artery and/or femoral artery accepted interventional therapies. The interventional therapeutic process included local thrombolytic therapy through endoarterial catheter, artery recanalization by guide wire, percutaneous transluminal angioplasty （PTA） and stent. After interventional operation, patients were administrated anticoagulant and antibiotics one week. Follow-up interval ranged 2 years. Wilcoxon test and t test were used for statistics. Results Immediate technical successful rate was 97. 6% （41/42） ,the secondary technical success rate was 100.0% （42/42）. The arterial occlusions were resolved successfully （local thrombolytic therapy in 26 cases, recanalization by guide wire in 31 cases, PTA in 33 cases and 60 stents in 31 cases ）. There were no severe complications （such as angiorrhexis, perforation） during interventional procedure. The symptoms of lower limb ischemia were palliated or vanished in all patients after interventional therapy. The ankle-brachnial index（ABI） of diseased extremities increased from pre-operation 0. 34 ± 0. 14 to post-operation 0. 65± 0.10 （ t = 25. 924, P 〈 0. 01 ）. During the follow-up, 11/42 （26. 2% ） iliac or femoral artery （ treated with local intra-arterial thrombolysis, PTA and stent） occurred restenosis. After PTA and stenting, the restenosis arteries became fluent successfully. The primary Potency rate was 92. 8% （39/42）and the secondary Potency rate was 100.0% （42/42） 1 year after the procedure. Two years after the procedure, the primary Potency rate was 71.4% （30/42） and the secondary patency rate was 97. 6% （41/42）. Conclusions Interventional therapy （including local thrombolysis, recanalization, PTA and stent） is an effective and safe therapy for occlusive lesion in iliacofemoral arterie

关 键 词：动脉闭塞性疾病 放射学 介入性 髂动脉 股动脉 

分 类 号：R686[医药卫生—骨科学]