斑块旋切术治疗糖尿病膝下动脉病变效果分析  

Directional atherectomy for the treatment of infrapopliteal arterial disease in diabetic patients:analysis of its curative effect

作　　者：崔文军[1] 王兵[1] 安乾[1] 司江涛[1] 王颖[1] 吴斐[1] 李阳[1] CUI Wenjun;WANG Bing;AN Qian;SI Jiangtao;WANG Ying;WU Fei;LI Yang(Department of Vascular Surgery, Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou, Henan Province 450052, China)

机构地区：[1]郑州大学第五附属医院血管外科,450052

出　　处：《介入放射学杂志》2019年第5期476-480,共5页Journal of Interventional Radiology

基　　金：河南省高等学校重点科研项目(16B320023);河南省医学科技攻关计划项目(201602142)

摘　　要：目的评价TurboHawk斑块旋切术治疗糖尿病患者膝下动脉病变的近中期临床疗效。方法回顾性分析2016年3月至2017年12月采用TurboHawk斑块旋切术治疗的21例糖尿病膝下动脉病变患者临床资料。比较手术前后患者临床症状、踝-肱指数(ABI)、趾-肱指数(TBI)、间歇性跛行距离,观察手术相关并发症,随访Fontaine分级、靶血管一期通畅率。结果 21例患者手术均取得成功。围手术期并发症发病率为14.3%(3/21),无死亡病例。术后患肢皮温升高,疼痛缓解,临床症状较术前明显减轻。随访10～16个月,平均(12.80±3.69)个月。Fontaine分级均较术前有不同程度改善。术后3、6、12个月ABI、TBI、间歇性跛行距离均较术前明显提高,差异均有统计学意义(P<0.05);靶血管一期通畅率分别为90.5%(19/21)、81.0%(17/21)、71.4%(15/21)。结论 TurboHawk斑块切除术治疗糖尿病患者膝下动脉病变安全有效。Objective To evaluate the short-medium-term clinical efficacy of TurboHawk atherectomy in treating diabetic patients with infrapopliteal artery occlusive disease. Methods The clinical data of 21 diabetic patients with infrapopliteal artery occlusive disease, who received TurboHawk atherectomy during the period from March 2016 to December 2017, were retrospectively analyzed. The postoperative clinical symptoms, ankle-brachial index(ABI), toe-brachial index(TBI), intermittent claudication distance were compared with the preoperative ones. The procedure-related complications, the follow-up Fontaine grade, and the primary patency rate of target vessels were recorded and evaluated. Results Successful TurboHawk atherectomy was accomplished in all 21 patients. The incidence of perioperative complications was 14.3%(3/21), no death occurred. After the treatment, the skin temperature of the affected limb was elevated, the pain was relieved, and the clinical symptoms were obviously alleviated when compared with preoperative ones. The patients were followed up for 10-16 months, with a mean of(12.80±3.69) months. The postoperative Fontaine grade was improved in different degrees when compared with the preoperative one. The 3-, 6-and12-month postoperative ABI, TBI and intermittent claudication distance were significantly better than those before operation, all the differences were statistically significant(P<0.05). The 3-, 6-and 12-month primary patency rates of target vessels were 90.5%(19/21), 81.0%(17/21) and 71.4%(15/21) respectively. Conclusion For the treatment of infrapopliteal artery occlusive disease in diabetic patients, TurboHawk atherectomy is clinically safe and effective.

关 键 词：斑块旋切术 糖尿病 动脉硬化闭塞症 膝下动脉 

分 类 号：R587[医药卫生—内分泌]