紫杉醇药物涂层球囊对症状性股腘动脉硬化闭塞症的疗效分析  

Analysis of the efficacy of paclitaxel drug-coated balloon in the treatment of symptomatic femoral and popliteal arteriosclerosis obliterans

作　　者：官泽宇[1] 宋涛[1] 任天才 余朝文[1] GUAN Ze-yu;SONG Tao;REN Tian-cai;YU Chao-wen(Department of Vascular Surgery,the First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,Anhui,China)

机构地区：[1]蚌埠医学院第一附属医院血管外科,安徽蚌埠233004

出　　处：《川北医学院学报》2022年第2期174-177,共4页Journal of North Sichuan Medical College

基　　金：安徽省科技厅项目(201904a07020020)。

摘　　要：目的:探讨紫杉醇药物涂层球囊对症状性股腘动脉硬化闭塞症的疗效。方法:选取62例症状性下肢动脉硬化闭塞症患者为研究对象,依据治疗方式不同分为观察组与对照组,每组各31例。观察组患者接受紫杉醇药物涂层球囊扩张成形治疗,对照组接受普通外周动脉金属支架治疗。比较两组患者手术前后不同时间疼痛评分(VAS评分)与间歇性跛行距离、Rutherford分级、最小管腔直径(MLD)及晚期管腔丢失(LLL)、患肢踝肱指数(ABI)、一期通畅率、术后12个月再狭窄率、主要不良事件发生率。结果:两组患者术后1周、术后1个月,VAS评分、与间歇性跛行距离、术后12个月Rutherford分级、术后6个月和术后12个月MLD与LLL,术后1周、术后3个月、术后6个月ABI均较术前改善(P<0.05),但组间比较,差异无统计学意义(P>0.05);观察组术后12个月ABI高于对照组(P<0.05);两组术后12个月一期通畅率比较,差异无统计学意义(P>0.05);观察组术后12个月再狭窄率低于对照组(P<0.05);两组随访过程中未出现死亡病例,术后无新发坏疽导致的大截肢,两组患者死亡率、截肢率比较,差异无统计学意义(P>0.05)。结论:紫杉醇药物涂层球囊扩张成形术对症状性股腘动脉硬化闭塞症的近期疗效与普通外周动脉金属支架相当,但术后1年ABI和再狭窄率优于金属支架。Objective:To investigate the effect of paclitaxel drug-coated balloon in the treatment of symptomatic femoral popliteal arteriosclerosis obliterans.Methods:62 patients with symptomatic lower extremity arteriosclerosis occlusive disease were selected and divided into observation group and control group according to different treatment methods,with 31 cases in each group.The observation group received paclitaxel drug-coated balloon dilation and the control group received general peripheral artery metal stent treatment.The pain score,intermittent claudication distance,Rutherford grading,minimum lumen diameter(MLD)and late lumen loss(LLL),ankle-brachial index ABI of affected limb,primary patency rate,restenosis rate 12 months after surgery,and incidence of major adverse events were compared between the two groups.Results:At 1 week and 1 month after operation,the VAS score and intermittent claudication distance,Rutherford grade at 12 months after operation,MLD and LLL at 6 months and 12 months after operation,ABI at 1 week,3 months and 6 months after operation were improved compared with those before operation(P<0.05),but there was no significant difference between the two groups(P>0.05).ABI value of observation group was higher than that of control group 12 months after operation(P<0.05).There was no significant difference in primary patency rate between the two groups 12 months after surgery(P>0.05).The restenosis rate of observation group was lower than that of the control group(P<0.05).There was no death in the two groups during the follow-up,and no major amputation caused by new gangrene in the two groups.There was no significant difference in mortality and amputation rate between the two groups(P>0.05).Conclusion:The short-term efficacy of paclitaxel drug-coated balloon dilatation for symptomatic femorpopliteal occlusions is comparable to that of conventional peripheral artery metal stents,but ABI and restenosis rates are superior to those of metal stents at 1 year postoperatively.

关 键 词：股腘动脉 动脉硬化闭塞症 药物涂层球囊 疗效分析 

分 类 号：R654.3[医药卫生—外科学]