经皮血管腔内血管成形术治疗下肢动脉硬化闭塞症患者的疗效及安全性评价  

Analysis on curative effects of percutaneous transluminal angioplasty in treatment of patients with arteriosclerosis obliteration of lower extremity

作　　者：何凡[1] 蔡进中[1] 王露平[1] 窦永充[1] 陈旭东[1] 

机构地区：[1]暨南大学第二临床医学院深圳市人民医院介入科,广东深圳518002

出　　处：《吉林大学学报（医学版）》2012年第6期1191-1195,共5页Journal of Jilin University：Medicine Edition

基　　金：广东省中医药局中医药强省科研立项基金资助课题(2007246)

摘　　要：目的:评价经皮血管腔内血管成形术(PTA)治疗下肢动脉硬化闭塞症患者的临床疗效及安全性,为提高下肢动脉硬化闭塞症的手术成功率提供临床依据。方法:下肢动脉硬化闭塞症患者30例,其中Fontain分期Ⅱ期患者11例,Ⅲ期患者7例,Ⅳ期患者12例,观察所有患者术中血管再通及治疗前后临床症状改善情况。结果:30例患者45支血管行PTA,成功开通42支血管,手术成功率为93.3%。开通血管中行超声斑块消融术血管10支,超声斑块消融+球囊成形术血管20支,超声斑块消融+球囊成形术+支架植入术血管12支。27例患者治疗后临床症状改善,其中FontainⅡ期患者11例(11/11),Ⅲ期患者7例(7/7),Ⅳ期患者9例(9/12)。FontainⅡ、Ⅲ期患者术后临床有效率比较差异无统计学意义(P>0.05),Ⅱ、Ⅲ期患者术后临床有效率高于Ⅳ期患者(P<0.05)。30例患者中仅1例发生严重并发症,无死亡患者。结论:多种血管腔内血管成形术联合应用可以提高下肢动脉硬化闭塞症的手术成功率;PTA治疗下肢动脉硬化闭塞症安全有效。Objective To evaluate the efficacy and safety of percutaneous transluminal angioplasty （PTA） in treatment of patients with arteriosclerosis obliteration of lower extremity, and to provide clinical evidence to improve the operation success rate of arteriosclerosis obliteration of lower extremity. Methods 30 patients with arteriosclerosis obliteration of lower extremity （Fontain II -IV stage） were submitted to PTA, in which 11 patients were Fontain II , 7 patients were Fontain III , 12 patients were Fontain IV. The recanalization of occlusion arteries and the improvement of clinical symptoms before and after operation were observed. Results 45 lower extremity arteries in 30 patients were performed with PTA. 42 lower extremity arteries were successfully recanalized, the opoeration success rate was 93.3%. In 42 reeanalized lower extremity arteries, 10 were performed with intravascular ultrasound ablation, 20 were performed with intravascular ultrasound ablation ＋balloon angiography, 12 were performed with intravascular ultrasound ablation ＋ ballon angiography＋ stenting. The clinical symptoms were ameliorated in 27 patients, in which 11 were Fontain II （11/11）, 7 were Fontain III （7/7）, 9 were Fontain IV （9/12）, so the clinical effective rate was 90%. There was no significant difference of short-term clinical effective rate between Fontain lI and Fontain III patients （P）0.05）. The short-term clinical effective rates were significantly different between Fontain II , III and Fontain IV patients （P〈0.05）. Oonclusion Combined treatment of a variety of endovascular angioplasty could improve the operation success rate of arteriosclerosis obliteration of lower extremity. PTA is a feasible and effective technique for eurring arteriosclerosis obliteration of lower extremity.

关 键 词：下肢动脉硬化闭塞症 经皮血管腔内血管成形术 超声斑块消融术 球囊成形术 

分 类 号：R543.5[医药卫生—心血管疾病]