主髂动脉硬化闭塞症的腔内治疗  

Endovascular treatment for aortoiliac artery disease of arteriosclerosis

作　　者：陈忠[1] 王盛[1] 唐小斌[1] 吴章敏[1] 刘晖[1] 寇镭[1] 李庆[1] 何楠[1] 张征[1] 贾云峰[1] 杨耀国[1] 吴庆华[1] 

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所血管外科,北京100029

出　　处：《心肺血管病杂志》2010年第6期446-448,467,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨主髂动脉硬化闭塞症的腔内治疗方法和初步临床经验。方法:2002年1月至2010年6月主髂动脉硬化闭塞症腔内治疗患者161例,其中4例行单纯髂动脉球囊扩张,157例患者行髂动脉球囊扩张及支架植入术,共植入支架207枚,其中累及腹主动脉末端的10例患者采用对吻技术行支架植入。结果:161例患者均成功完成手术。术后患者踝臂指数(ABI)由术前的0.46±0.28提高至0.89±0.26,二者差异有统计学意义(P<0.01)。间歇性跛行及静息痛症状均较术前有明显改善。围手术期并发症包括急性血栓形成2例,穿刺部位血肿4例,肺部感染2例,脑梗死2例,急性心肌梗死1例,消化道出血2例。其中1例患者术后出现应激性溃疡消化道出血,后并发多脏器功能衰竭死亡,围手术期死亡率为0.62%,随访12个月的一期通畅率为91.8%,二期通畅率为100%。结论:主髂动脉病变的腔内治疗有良好的效果,部分复杂病变使用杂交技术可以提高成功率及通畅率。Objective：To investigate the endovascular treatment for aortoiliac disease of arteriosclerosis.Methods：161 patients received endovascular treatment from January,2002 to June,2010,which including angioplasty in 4 cases,angioplasty and stenting in 157 cases.207 stents were implanted.Kissing technique was used in 10 patients.Results：All procedures were completed successfully.Ankle-brachial index（ABI） increased from（0.46 ± 0.28） to（0.89 ± 0.26）,there was a significant difference（P 0.01）.Intermittent claudication and rest pain were relieved in all cases.Complications included thrombosis in 2 cases,hematoma in 4 cases,pulmonary infection in 2 cases,cerebral infarction in 2 cases,myoctardial in 1 case,alimentary tract hemorrhage in 2 cases.1 patient died of alimentary tract hemorrhage and multiple organs failure,peroperative period mortality was 0.62%.The primary patency was 91.8%,the second patency was 100%.Conclusion：Good results were found in aortoilia arteriosclerosis patients treated with endovascular technique,hybrid technique can be used in some patients.

关 键 词：动脉硬化闭塞症 髂动脉 腔内成形术 支架 血管疾病 

分 类 号：U543[交通运输工程]