序贯球囊扩张与单次球囊扩张治疗下肢动脉闭塞性疾病的早期疗效比较  

Efficacy of sequential or single balloon angioplasty in treatment of lower extremity arterial occlusive diseases

作　　者：庄晖[1] 郭平凡[1] 詹腾辉[1] 陈宏宇[1] 陈诚[1] Zhuang Hui Guo Pingfan Zhan Tenghui Chen Hongyu Chen Cheng(Department of Vascular Surgery, t-he First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Chin)

机构地区：[1]福建医科大学附属第一医院血管外科,福州350005

出　　处：《中华全科医师杂志》2016年第12期941-944,共4页Chinese Journal of General Practitioners

基　　金：福建省教育厅中青年教师项目（JA15223）

摘　　要：目的：比较序贯球囊扩张技术和传统单次球囊扩张技术开通股腘动脉慢性完全闭塞性病变（CTO）腔内治疗的疗效。方法2015年7月至2016年1月30例CTO患者（30条患肢）行序贯球囊扩张治疗（序贯组），以2014年1月至2015年6月82例行单次球囊扩张治疗的CTO患者（82条患肢）为对照（对照组）。两组平均年龄（70±8）与（74±8）岁（χ2＝0.046， P＝0.876），卢瑟福分级3.9±0.9与4.0±0.8（χ2＝0.315， P＝0.749）、术前踝肱比值（ABI）0.49±0.17与0.46±0.18（χ2＝－0.871， P＝0.388）、伴随疾病（χ2＝2.024， P＝0.567）、流出道情况（χ2＝4.678， P＝0.914）等比较，差异均无统计学意义。比较两组患者残余狭窄发生率、夹层发生率、使用支架长度、数量、卢瑟福分级变化、ABI、住院费用、手术费用及6个月随访结果。结果序贯组与对照组比较，术中残余狭窄发生率[13％（4／30）比37％（30／82）]，明显降低（χ2＝5.617， P＝0.018）；术中补救性支架长度23[（832） mm比59（2767） mm]明显降低（t＝－2.929， P＝0.004），差异有统计学意义；住院费用、手术费用基本相近，差异无统计学意义（ P＞0.05）；卢瑟福分级、术后ABI、术后6个月ABI、再干预率、二次干预费用等其他随访指标基本相近，差异无统计学意义（ P＞0.05）。结论序贯球囊扩张提高球囊扩张疗效，减少残余狭窄和支架使用，可以作为一种新的股腘动脉腔内技术进行运用。Objective To compare the therapeutic effect of sequential balloon angioplasty with conventional single balloon angioplasty in treatment of chronic total occlusion （ CTO ） of femoropopliteal artery.Method Thirty patients with femoropopliteal CTO treated with sequential balloon angioplasty from July 2015 to January 2016 （ sequential group ） , and 82 patients were treated with conventional single angioplasty from January 2014 to June 2015 （ control group ）.There were no differences in age [ （ 70 ±8 ） vs.（74 ±8） years,χ2 =0.046, P =0.876],Rutherford classification （3.9 ±0.9 vs.4.0 ±0.8,χ2 =0.315, P=0.749）,ankle-brachial pressure index （ABI）（0.49 ±0.17 vs.0.46 ±0.18,χ2 =-0.871, P=0.388）,comorbidity（χ2 =2.024, P=0.567） and outflow vessels （χ2 =4.678, P=0.914） between two groups.The Residual stenosis rate, dissection rate, stent length, stent number, Rutherford classification, ankle-brachial pressure index （ ABI） ,hospitalization expenses ,surgery expenses and 6-months follow-up were documented and compared between two groups.Results Compared with conventional single angioplasty group, the residual stenosis rate [13%（4/30） vs.37%（30/82）,χ2 =5.617, P=0.018] was lower and stent lengths [（23.3 ±47.2） mm vs.（58.7 ±75.4） mm, t =-2.929, P =0.004] was shorter in sequential group without increase of hospitalization expenses and surgery expenses .There were no differences in Rutherford classification and ABI after operation , ABI at 6-month follow-up, reoperation rate and cost of second operation between two groups.Conclusions Sequential balloon angioplasty technique can be use as an effective balloon expansion procedure in treatment of femoropopliteal artery occlusive disease .

关 键 词：外周血管疾病 动脉闭塞性疾病 血管成形术 气囊 序贯 

分 类 号：R654.4[医药卫生—外科学]