药物涂层球囊经皮腔内血管成形术治疗下肢动脉硬化闭塞症的临床效果  

Clinical effect observation of percutaneous transluminal angioplasty with drug-coated balloon in the treatment of arteriosclerosis obliterans of lower extremities

作　　者：赵旭[1] 任昊[1] 王刃[1] ZHAO Xu;REN Hao;WANG Ren(Department of Vascular Surgery,Dalian Municipal Central Hospital,Dalian116021,China)

机构地区：[1]大连市中心医院血管外科,辽宁大连116021

出　　处：《中国现代医生》2021年第14期66-69,共4页China Modern Doctor

摘　　要：目的探讨针对下肢动脉硬化闭塞症患者使用药物涂层球囊(DCB)开展经皮腔内血管成形术(PTA)的价值。方法选取本院2018年2月至2020年2月下肢动脉硬化闭塞症患者50例开展研究,采用随机数字表法分组,其中25例患者使用普通球囊开展PTA术治疗(研究1组),另外25例则选择药物涂层球囊开展PTA术(研究2组),评估两组患者踝肱指数(ABI)、下肢动脉最小管腔直径(MLD)、下肢动脉狭窄程度以及晚期管腔丢失(LLL)值等指标改善情况,并统计Rutherford分级>3级与≤3级人数占比、靶病变血运重建(TLR)发生率、再狭窄率、截肢率及不良事件发生率。结果研究2组术后3个月患者ABI为(0.78±0.19)、下肢动脉MLD为(3.57±0.56)mm、下肢动脉狭窄程度为(24.82±7.19)%、LLL值为(0.45±0.09)mm,均优于研究1组的(0.53±0.15)、(2.01±0.35)mm、(58.26±6.18)%、(1.67±0.24)mm(P<0.05);Rutherford分级情况中研究2组Rutherford分级>3级人数占比为24.00%,显著低于研究1组的60.00%(P<0.05);再狭窄率、TLR发生率及截肢率分别为12.00%、8.00%、4.00%,均低于研究1组的68.00%、56.00%及12.00%(P<0.05)。结论DCB在下肢动脉硬化闭塞症患者PTA术中合理应用,能够显著提高ABI值、改善动脉狭窄情况,促使患者下肢动脉血流恢复,有效避免再狭窄情况发生,避免截肢。Objective To explore the value of percutaneous transluminal angioplasty(PTA)with drug-coated balloon(DCB)for patients with arteriosclerosis obliterans of lower limbs.Methods A total of 50 patients with arteriosclerosis obliterans of lower limbs admitted in our hospital from February 2018 to February 2020 were enrolled in this study.Those patients were divided into groups by random number table,in which 25 patients were treated with PTA with ordinary balloon(study group 1)and the other 25 patients were treated with PTA with drug-coated balloon(study group 2).The ankle-brachial index(ABI),minimum lumen diameter(MLD)of lower limb artery,stenosis degree of lower limb artery and late lumen loss(LLL)were evaluated in both groups.The proportion of Rutherford grade>grade 3 and≤grade 3,the incidence of target lesion revascularization(TLR),restenosis rate,amputation rate and the incidence of adverse events were counted.Results Three months after operation,ABI,MLD of lower limb artery,stenosis degree of lower limb artery and LLL value in the study group 2 were(0.78±0.19),(3.57±0.56)mm,(24.82±7.19)%and(0.45±0.09)mm,respectively,which were better than those in study group 1[(0.53±0.15),(2.01±0.35)mm,(58.26±6.18)%and(1.67±0.24)mm](P<0.05).The proportion of people with Rutherford classification>grade 3 in the study group 2 was 24.00%,which was significantly lower than that in study group 1(60.00%,P<0.05).The restenosis rate,TLR rate and amputation rate in the study group 2 were 12.00%,8.00%and 4.00%,respectively,which were lower than those in the study group 1(68.00%,56.00%and 12.00%,P<0.05).Conclusion The rational application of DCB in PTA for patients with arteriosclerosis obliterans of lower limbs can significantly improve ABI value and arterial stenosis,promote the recovery of arterial blood flow of patients′lower limbs,and effectively avoid restenosis and amputation.

关 键 词：药物涂层球囊 经皮腔内血管成形术 下肢动脉硬化闭塞症 踝肱指数 再狭窄率 

分 类 号：R654.3[医药卫生—外科学]