保守与介入治疗Fontaine Ⅱ期下肢动脉硬化闭塞症患者近期和远期疗效对比  

Comparison of short and long term curative effect between conservative and interventional therapy in Fontaine stageⅡpatients with lower extremity arteriosclerosis obliterans

作　　者：李琳琳 李光新[1] 王宾[1] Li linlin;Li Guangxin;Wang Bin(Department of General Surgery,the First Affiliated Hospital of Shandong First Medical University(Shandong Provincial Qianfoshan Hospital),Jinan 250014,China)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)普通外科,济南250014

出　　处：《中华普通外科杂志》2021年第12期931-935,共5页Chinese Journal of General Surgery

摘　　要：目的探讨保守治疗与介入治疗对Fontaine Ⅱ期下肢动脉硬化闭塞症患者的近、远期疗效。方法回顾性分析山东第一医科大学第一附属医院血管外科2014年6月至2017年6月收治的184例(219条肢体)Fontaine Ⅱ期下肢动脉硬化闭塞症患者,根据治疗方式不同分为保守治疗组93条肢体,介入治疗组126条肢体,比较两组患者临床疗效。结果介入治疗组近期总有效率显著优于保守治疗组(83.33%比45.16%),差异有统计学意义(P<0.05);1年随访期内介入治疗组总有效率优于保守治疗组(60.32%比53.76%),但差异无统计学意义(P>0.05);3年随访期内保守治疗组总有效率优于介入治疗组(60.21%比53.17%),差异无统计学意义(P>0.05);随访期内保守治疗组全因死亡、截肢、心脑血管事件发生率均低于介入治疗组,但差异无统计学意义(P>0.05);3年随访期介入治疗组病变动脉再狭窄率和再次干预率更高,差异有统计学意义(P<0.05)。结论与介入治疗相比,Fontaine Ⅱ期下肢动脉硬化闭塞症患者保守治疗经济、安全、有效。Objective To compare the short-and long-term effects of conservative and interventional treatment in patients with lower extremity arteriosclerosis obliterans of Fontaine stageⅡ.Methods This is a retrospective analysis,184 patients(219 limbs)admitted to the Department of Vascular Surgery,First Affiliated Hospital of Shandong First Medical University from Jun 2014 to Jun 2017,were divided into the conservative treatment group(93 limbs)and interventional treatment group(126 limbs).Results The short-term effective rate in the intervention group was better than that of the conservative group(83.33%vs.45.16%,P<0.05).After one year follow-up,the total effective rate in the groups was similar(60.32%vs.53.76%,P>0.05).While the total effective rate of the conservative group was better than that of the intervention group(60.21%vs.53.17%)after the 3-year follow-up,though the differences were not statistically significant(P>0.05).The rates of all-cause death,amputation,and cardiovascular events in the conservative group were lower;though the difference was not significant(P>0.05).However,the intervention group had a significantly higher rate of restenosis and re-intervention rate during the 3-year follow-up period(P<0.05).Conclusion Compared to intervention group,the conservative treatment is more economical,effective and safe for patients with lower extremity arteriosclerosis obliterans of Fontaine stageⅡ.

关 键 词：动脉闭塞性疾病 治疗结果 保守治疗 介入治疗 

分 类 号：R654.4[医药卫生—外科学]