糖尿病性和非糖尿病性下肢动脉硬化闭塞症患者的腔内治疗对比分析  

Curative effect of PTA on lower limb atherosclerosis obliterans in diabetic and non-diabetic patients

作　　者：娄尧强[1] 徐侃[1] 王林君[1] 王松茂[1] 金晔[1] 孟路阳[1] 

机构地区：[1]杭州市第三人民医院血管外科,310009

出　　处：《中华老年心脑血管病杂志》2012年第12期1245-1247,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨糖尿病性和非糖尿病性下肢动脉硬化闭塞症(ASO)行经皮血管内成形术(PTA)的疗效。方法回顾性分析行PTA治疗下肢ASO患者97例。观察糖尿病性ASO(糖尿病组)32例和非糖尿病性ASO(非糖尿病组)65例临床表现、合并症、病变位置、手术成功率、静息痛缓解率、渍疡愈合率、截肢率和踝肱指数变化等。结果所有患者中,围手术期死亡1例,总随访率87.6%。糖尿病组PTA成功率87.7%,置入支架16枚,随访中再次行PTA 4例,截肢5例。非糖尿病组PTA成功率96.1%,置入支架48枚,随访中再次行PTA 9例,截肢7例。54例静息痛患者,术后疼痛消失45例(83.3%),25例溃疡,术后愈合16例(64.0%)。结论 PTA治疗糖尿病性ASO和非糖尿病性效果满意,是一个理想的选择,尤其是对那些远端流出道不良的病例。Objective To study the curative effect of PTA on lower limb atherosclerosis obliterans in diabetic and nondiabetic patients. Methods Ninetyseven diabetic and nondiabetic patients with lower limb atherosclerosis obliterans admitted to our hospital from September 2007 to Octo ber 2011 for PTA were retrospectively analyzed. Their clinical manifestations, complications, le sion location, operation success rate, rest pain alleviating rate, ulcer healing rate, amputation rate and anklebrachial index（ABI） were observed. Results One patient died during perioperative pe riod. The followup rate was 87.6% The success rate of PTA was 87.7G in diabetic patients into whom 16 stents were implanted. Four patients underwent a second PTA during followup and 5 patients received amputation. The success rate of PTA was 96.1% in nondiabetic patients into whom 48 stents were implanted. Nine patients underwent a second PTA during followup and 7 patients received amputation. The rest pain disappeared in 45 patients（83.3%）and the ulcer was healed in 16 patients（64.0%）. Conclusion PTA is an ideal procedure for lower limb atheroscle rosis obliterans in diabetic and nondiabetic patients, especially for those with poor distal flow, and can achieve satisfactory clinical outcomes.

关 键 词：下肢 动脉粥样硬化 间歇性跛行 糖尿病 支架 

分 类 号：R587.2[医药卫生—内分泌] R543.5[医药卫生—内科学]