髂动脉病变腔内治疗围手术期并发症的防治  

Prevention and treatment of perioperative complication during endovascular treatment for iliac artery lesion

作　　者：李庆[1] 陈忠[1] 唐小斌[1] 吴章敏[1] 寇镭[1] 刘晖[1] 王盛[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,100029

出　　处：《心肺血管病杂志》2012年第1期54-57,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨应用腔内技术,治疗髂动脉动脉硬化性狭窄或闭塞术中,围手术期常见并发症及其处理。方法:自2006年6月至2010年6月,105例患者的130条髂动脉病变血管,应用腔内成形术及支架植入术。结果:128条髂动脉病变血管腔内治疗操作获成功,2条髂动脉闭塞尝试开通失败。术后患者踝臂指数(ABI)由术前的0.44±0.15,提高至0.79±0.22,二者差异有统计学意义(P<0.01)。围手术期并发症发生率14.2%,包括术前1例急性心肌梗死,1例肺部感染,术中1例闭塞髂动脉开通中破裂,2例肱动脉血栓形成,2例术中出现对侧肢体栓塞,术后2例患者股动脉术后出现假性动脉瘤,穿刺部位血肿4例,肺部感染2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,围手术期病死率为0.9%。随访12个月的一期通畅率为94.3%,二期通畅率为100%。结论:腔内治疗对于髂动脉病变有良好的治疗效果,但治疗同时尽可能减少围手术期局部及全身并发症。Objective：To investigate the prevention and treatment of perioperative complication during endovascular treatment for iliac artery stenosis or occlusion of arteriosclerosis.Methods：130 iliac arteries lesion in 105 patients received endovascular treatment from June,2006 to June,2010.Results： All procedures were completed successfully except 2 iliac arteries occlusion.Ankle-brachial index（ABI） increased from（0.46 ± 0.28） to（0.79 ± 0.22）,there was a significant difference（P〈0.01）.Operative complications rate was 14.2%,including 1 acute myocardium infarction and 1 pulmonary infection before operation,1 iliac artery rupture and 2 contralateral limb arteries embolism during operation,2 brachial arteries thrombosis,2 femoral arteries pseudoaneurysm,4 groin hematomas,2 pulmonary infection and 2 alimentary tract hemorrhage after operation.1 patient died of stress ulcer and alimentary tract hemorrhage,and multiple organs failure,perioperative period mortality was 0.9%.The primary patency was 94.3%,the second patency was 100%.Conclusion： Good results were found in iliac arteriosclerosis patients treated with endovascular technique,local and systemic perioperative complications should be avoided as few as possible.

关 键 词：髂动脉狭窄 闭塞 腔内治疗 围手术期 并发症 

分 类 号：R543[医药卫生—心血管疾病]