主髂动脉硬化闭塞症腔内治疗的术式选择及效果  

Effect of endovascular treatment for aorto-iliac artery occlusive disease

作　　者：李春民 任华亮 冷瑞 王祺 张望德 LI Chunmin;REN Hualiang;LENG Rui;WANG Qi;ZHANG Wangde(Department of Vascular Surgery,Beijing Chaoyang Hospital Affiliated to Capital Cedical University,Beijing 100020,P.R.China)

机构地区：[1]首都医科大学附属北京朝阳医院血管外科首都医科大学血管外科学系

出　　处：《中国普外基础与临床杂志》2019年第10期1201-1204,共4页Chinese Journal of Bases and Clinics In General Surgery

摘　　要：目的探讨腔内治疗方法治疗主髂动脉硬化闭塞症的技术经验及近远期效果。方法回顾性分析首都医科大学附属北京朝阳医院血管外科于2013年6月至2017年5月期间收治的131主髂动脉硬化闭塞症患者的临床资料。结果131例患者均实施了手术操作,其中行单纯主髂动脉置管溶栓术5例,主髂动脉球囊扩张+支架置入94例,置管溶栓术+球囊扩张支架置入23例,单纯球囊扩张3例,6例复杂病例同期实施了杂交手术。平均手术时间90min,平均住院时间5d。术后发生穿刺部位血肿3例,腹膜后血肿1例,急性暂时性缺血性卒中发作1例,肺内感染1例。术后113例获访,成功随访率为86.3%(113/131);随访时间1~32个月,中位随访时间为16个月。随访期间死亡2例,1例死于心肌梗塞,1例死于多器官功能衰竭。随访1年内的通畅率为89.3%(100/112)。随访期间13例复发,其中5例实施了再次支架置入,1例实施了置管溶栓术+经皮腔内血管成形术(PTA),另外7例因症状较轻予以保守治疗。结论主髂动脉硬化闭塞症的处理仍需根据病变情况选择合理的措施,甚至几种措施相结合,使病变处理更简化,风险更低,效果更好。Objective To explore the technique experience and short- term and long-term effect of endovascular treatment on aorioiliac artery occlusive disease. Methods Clinical data of 131 patients were admitted for aorioiliac artery occlusive disease in the Department of Vascular Surgery of Beijing Chaoyang Hospital Affiliated to Capital Cedical University in recent years were analyzed. Results All the 131 patients underwent surgical operation, including 5 cases of pure catheterization (CDT);94 cases of balloon dilatation and stent implantation;23 cases which combind CDT, balloon dilatation, and stent implantation;3 cases of pure balloon dilatation and 6 complicated cases of hybrid surgery. The mean operative time was 90 minutes, mean hospitaliztion time was 5 days. There were 6 cases occurred complications during perioperative period, including 3 cases of hematoma, 1 case of retroperitoneal hematoma, 1 case of acute transient ischemic attacks (TIA), and 1 case of pulmonary infection. There were 113 patients were followed-up for 1–32 months, and the median time was 16 months, the follow-up rate was 86.3%(113/131). During the follow-up period, 2 patients died, 1 died of myocardial infarction and 1 died of multi-organ failure. The one-year patency rate was 89.3%(100/112). During the follow-up period, 13 patients relapsed, including 5 patients who underwent secondary stent implantation, 1 patient who underwent CDT and percutaneous transluminal angioplasty (PTA), and 7 patients who received conservative treatment due to mild symptoms. Conclusions The treatment of aorioiliac artery occlusive disease still needs to choose reasonable measures according to the lesions, and even several measures should be combined to simplify the lesions, lower risk and receive better effect.

关 键 词：主髂动脉硬化闭塞症 腔内治疗 效果 

分 类 号：R654.3[医药卫生—外科学]