下肢动脉闭塞性病变介入开通治疗的策略  

Tactic of interventional therapy for occlusive lesion in arteries of lower extremity

作　　者：肖亮[1] 童家杰[1] 申景[1] 徐克[1] 

机构地区：[1]中国医科大学附属第一医院,110001

出　　处：《山西医药杂志（上半月）》2011年第1期6-8,共3页Shanxi Medical Journal

基　　金：国家十一五科技支撑计划(2007BAI05B04)

摘　　要：目的探讨采用介入方法治疗下肢动脉闭塞性病变的临床策略。方法 2001年2月至2009年11月期间我院介入病房收治的76例经数字减影血管造影（DSA）证实为髂动脉和/或股动脉闭塞的患者,男性45例,女性31例,年龄32～85岁。闭塞段长度1～40 cm,发病时间10 h至30年。术中分别采用经导管动脉内溶栓、导丝机械开通、经皮血管腔内成形术（PTA）、支架置入术等方法,术后给予抗凝及抗炎治疗1周,随访12个月至5年。结果总的技术成功率为97%（74/76）。本组治疗中,溶栓治疗26例,机械开通65例,PTA68例,支架置入62例。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。随访期间11例患者再次出现下肢缺血症状。其余62例症状无复发,血管超声复查提示管腔通畅、血流良好。结论介入治疗肢体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 explore the interventional therapeutic tactic of occlusive lesion in arteries of lower extremity.Methods During Feb 2001 to Nov 2009,seventy-six patients（45 male and 31 female） whose arterial occlusive lesions in iliac artery and/or femoral artery had been diagnosed by DSA accepted interventional therapies.Among 76 patients,the length of occlusive arteries ranged from 1 cm to 40 cm,the interval between symptom emerging and interventional therapeutic beginning ranged from 10 hours to 30 years.The interventional therapeutic tools included local thrombolytic therapy through endoarterial catheter,artery recanalization by guide wire,PTA and stent.After interventional operation,patients were administrated anticoagulant and antibiotics for one week.Follow-up interval ranged 1~5 years.Results Immediate technical success rate was 97%（74/76 cases）.The arterial occlusions were resolved successfully（local thrombolytic therapy in 26 cases,recanalization by guide wire in 65cases,PTA in 68 cases and stent in 62 cases）.There were not 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.During the follow-up,11/74（15%） iliac or femoral artery（treated with local intra-arterial thrombolysis,PTA and stent） occurred restenosis.The other 62 patients did not suffer the symptoms of lower limb ischemia during the follow-up.The blood flow of arteries treated still kept fluent confirmed by Doppler ultrasound.Conclusion Interventional therapy（included local thrombolysis,recanalization,PTA and stent） was an effective and safe therapy for occlusive lesion in lower extremity arteries.

关 键 词：动脉闭塞性疾病 下肢 介入治疗 

分 类 号：R543[医药卫生—心血管疾病]