血运重建治疗主髂动脉闭塞及狭窄  

A comparative study of revascularization treatment for patients with iliac artery occlusion vs stenosis

作　　者：张建彬[1] 徐荣伟[1] 刘鹏[1] 甄亚楠 叶志东[2] 

机构地区：[1]北京协和医学院研究生院,100730 [2]中日友好医院心脏血管外科

出　　处：《中华普通外科杂志》2016年第4期301-304,共4页Chinese Journal of General Surgery

摘　　要：目的比较血运重建治疗主髂动脉闭塞及狭窄的疗效及早期通畅率。方法回顾性分析北京协和医学院和中日友好医院2009年1月至2014年4月收治的105例主髂动脉闭塞及狭窄行血运重建治疗患者的临床资料，其中闭塞组49例，狭窄组56例，对2组患者的术前状况、手术过程、并发症及早期通畅率进行比较。结果闭塞组和狭窄组在性别、年龄、合并症等方面比较差异无统计学意义。术前存在急性下肢缺血患者的比例闭塞组明显高于狭窄组（91．84％比67．86％，P=0．003），闭塞组踝-肱指数（ABI）明显低于狭窄组（0．35±0．12比0．59±0．14，P〈0．001）；手术方面闭塞组进行杂交手术手术的比例高于狭窄组（40．82％比12．50％，P=0．001）；围手术期并发症发生率闭塞组比狭窄组略高（12．24％比5．36％，P=0．299），但差异无统计学意义；所有患者ABI较术前均有提高（0．86±0．22比0．48±0．18，P〈0．001），早期通畅率方面2组差异无统计学意义（89．80％比91．17％，P=0．828）。结论血运重建治疗主髂动脉闭塞和狭窄病变均安全有效，两者具有相似的早期通畅率，围手术期并发症闭塞病变略高。Objective To compare the outcome and early patency rate of revascularization treatment for patients with iliac artery occlusion or stenosis. Methods Retrospective analysis was made on 105 cases of iliac artery occlusion or stenosis from January 2009 to April 2014. 49 were with iliac artery occlusion and 56 with iliae artery stenosis. Results The demographics, and comorbidities were not statistically different between the 2 groups. The occlusion group had more critical limb isehemia and the ankle-brachial index was lower than the stenosis group. The occlusion group underwent more hybrid surgery and used more covered stents in the operation. The peri-operative complication was higher in the occlusion group, but the difference was not statistically different. The ABI improved significantly for all patients after surgery. The early patency rate was similar in the 2 groups. Conclusions Revascularization treatment for patients with iliae artery occlusion and stenosis was safe and effective, with similar early patency rate and peri-operative complications between the two groups.

关 键 词：闭塞性动脉硬化 血管成形术 支架 

分 类 号：R654.3[医药卫生—外科学]