腔内治疗和人工血管搭桥术在治疗股-腘动脉段动脉硬化闭塞症TASCⅡB、C级时的应用及预后  

Application of intra-cavity therapy and artificial vascular bypass grafting in treating TASCII B and C type arteriosclerosis obliterans in the segment of thigh and popliteal artery and the prognosis

作　　者：陶源 黄忍 林晨琛 王孝高[1] 余朝文[1] TAO Yuan(Adult education institute,the first affiliated hospital of Bengbu Medical College,Bengbu,Anhui,233000,China.)

机构地区：[1]蚌埠医学院第一附属医院,安徽蚌埠233000

出　　处：《齐齐哈尔医学院学报》2020年第9期1087-1089,共3页Journal of Qiqihar Medical University

基　　金：蚌埠医学院自然科学基金重点项目(BYKY1862ZD)。

摘　　要：目的比较腔内治疗和人工血管搭桥术两种手术方式治疗股—腘动脉段动脉硬化闭塞症ⅡB、C级的预后情况。方法选择2016年8月—2018年8月在本院血管外科因股-腘动脉段动脉硬化闭塞症ⅡB、C级行手术治疗的患者59例作为研究对象,分为腔内治疗组(39例)和人工血管组(20例)两组,比较分析两组患者术后近期(术后6个月以内)病情好转率、ABI指数恢复情况,以及中远期(1~3年)血管通畅率、肢体存活率。结果腔内治疗组近期好转率为89.74%,人工血管组为70.00%,差异无统计学意义(P>0.05);腔内治疗组术后ABI指数基本或完全恢复(0.80≤ABI≤0.90)的比率为92.31%,人工血管组为75.00%,差异无统计学意义(P>0.05)。腔内治疗组中远期血管通畅率为94.74%,人工血管组为62.50%(P>0.05);腔内治疗组肢体存活率为93.48%,人工血管组为69.23%,差异均具有统计学意义(P<0.05)。结论在治疗股-腘动脉段动脉硬化闭塞征ⅡB、C级时,腔内介入和人工血管搭桥在近期都能有效疏通下肢动脉硬化闭塞症患者闭塞血管,而在中远期血管通畅率、保肢率上,介入治疗则有较为明显的优势。Objective To compare the prognosis of IIB and IIC type arteriosclerosis obliterans in femoral-popliteal artery segment by two surgical methods,and to select a better treatment scheme.Methods 59 patients with IIB or IIC type arteriosclerosis in the femoral-popliteal artery segment and received surgical treatment in the first affiliated Hospital of Bengbu Medical College from August 2016 to August 2018 were selected as study subjects.All the patients were divided into intra-cavity treatment group(n=39)and artificial vascular group(n=20).The improvement rate,ABI index recovery in the short term(less than 6 months after operation),vascular patency rate and limb survival rate in middle and long term(1-3 years)between the two groups were compared and analyzed.Results The recent improvement rate was 89.74%in the endovascular treatment group and 70.00%in the artificial blood vessel group,and the difference was not statistically significant(P>0.05).The ratio of basic or complete recovery of ABI index(0.80≤ABI≤0.90)in the endovascular treatment group was 92.31%and 75.00%in the artificial blood vessel group,and the difference was not statistically significant(P>0.05).The long-term vascular patency rate was 94.74%in the intra-cavity treatment group,62.50%in the artificial vascular group(P<0.05).The survival rate was 93.48%in the intra-cavity treatment group and 69.23%in the artificial vascular group,and all of the differences were statistically significant.Conclusions In the treatment of femoral-popliteal arteriosclerosis occlusion of IIB and IIC grade,both intra-luminal intervention and artificial vascular bypass could dredge the occluded blood vessels of patients with lower extremity arteriosclerosis occlusion in the near future,while in the middle and long-term vascular patency rate,limb preservation rate,interventional treatment has more obvious advantages.

关 键 词：腔内治疗 人工血管搭桥术 股-腘动脉 动脉硬化闭塞症 TASCⅡB、C级 

分 类 号：R783.3[医药卫生—口腔医学]