球囊扩张成形术与斑块切除术治疗腘动脉闭塞症的临床效果比较  

Comparison of clinical effects between balloon dilatation and atherectomy for popliteal artery occlusion

作　　者：李新胜[1] 成岗[1] 张猛 LI Xin-sheng;CHENG Gang;ZHANG Meng(Department of Interventional Vascular,Wuxi Third People＇s Hospital,Jiangsu,Wuxi 214041,China)

机构地区：[1]无锡市第三人民医院介入血管科,江苏无锡214041

出　　处：《中国医学前沿杂志（电子版）》2018年第11期128-132,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探讨球囊扩张成形术和斑块切除术治疗腘动脉闭塞症的临床效果。方法回顾性分析2016年3月至2017年9月本院收治的98例腘动脉闭塞症患者的临床资料,根据治疗方式将入选患者分为观察组(68例,采用球囊扩张成形术治疗)和对照组(30例,采用斑块切除术治疗)。比较两组患者的溃疡变化情况、间歇性跛行距离和缓解时间、踝肱指数、患肢腘动脉周围皮肤温度变化情况及随访1年术后再狭窄发生率。结果术后1个月,观察组患者溃疡面积小于对照组(P <0.05),溃疡部位肉芽评分显著低于对照组(P <0.05),间歇性跛行距离显著长于对照组(P <0.05)。但两组患者术前及术后1个月间歇性跛行缓解时间比较差异均无显著性(P_均> 0.05)。观察组患者术后7天踝肱指数显著高于对照组(P <0.05),两组患者术前和术后24小时患肢腘动脉周围皮肤温度、术后通畅率、术后并发症发生率及再狭窄发生率比较差异均无显著性(P_均>0.05)。结论球囊扩张成形术治疗腘动脉闭塞症有利于缩小溃疡面积、促进伤口愈合(肉芽组织同期更少)、增加间歇性跛行距离、提高踝肱踝肱指数,但术后通畅率、并发症发生率、再狭窄率与斑块切除术相当,远期临床疗效仍需进一步观察。Objective To investigate the clinical effects of balloon dilatation and atherectomy for popliteal artery occlusion. Method The clinical data of 98 patients with popliteal artery occlusion who were admitted to our hospital from March 2016 to September 2017 were retxospectively analyzed. According to the treatment, 68 patients treated with balloon dilatation were included in observation group, and 30 petients treated with atherectomy were included in control group. The ulcer changes, intermittent claudication distance and remission time, oaakle-brachial index, skin temperature changes around the popliteal oxtery, and 1 year postoperative restenosis were compared between the two groups. Result 1 month after operation, the ulcer area of observation group were significantly smaller than those in control group （P 〈 0.05）, and the ulcer granulation score was significantly lower than control group （P 〈 0.05）, the intermittent claudication distance was significantly longer than that in control group （P 〈 0.05）. But there were no significant differences in the time of intermittent claudication between the two groups before and 1 month after surgery （Pall 〉 0.05）. 7 days after operation, the anklebrachial index in observation group was significantly higher than that in control group （P 〈 0.05）. There were no significant differences in skin temperature changes around the popliteal artery before and 24 hours after operation, operative patency rate, postoperative complications and restenosis between the two groups （Pall 〉 0.05）. Conclusion Balloon dilatation in the treatment of popliteal artery occlusion is beneficial to reduce ulcer area, promote wound healing （less granulation tissue）, increase intermittent claudication distance, increase anlde-brachial index, but its postoperative potency rate, complication rate, and the stenosis rate ore comparable to atherectomy, and long-term clinical efficacy still needs further observation.

关 键 词：腘动脉 球囊扩张成形术 临床效果 踝肱指数 

分 类 号：R654.4[医药卫生—外科学]