应用血管内支架治疗下肢动脉硬化性闭塞症40例疗效分析  

Clinical efficacy of endovascular stent therapy for treatment of lower extremity atherosclerotic occlusive disease in 40 patients

作　　者：余桂林 方圆 Yu Guilin;Fang Yuan(Department of Vascular Surgery,Lishui Central Hospital,Lishui 323000,Zhejiang Province,China;Department of Vascular Surgery,Lishui City People's Hospital,Lishui 323000,Zhejiang Province,China)

机构地区：[1]丽水市中心医院血管外科,丽水323000 [2]丽水市人民医院血管外科,丽水323000

出　　处：《中国基层医药》2022年第11期1659-1663,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省自然科学基金青年基金 (Q13C020015)。

摘　　要：目的分析应用血管内支架治疗下肢动脉硬化性闭塞症(ASO)患者的近远期疗效。方法选取丽水市中心医院2020年1月至2021年1月收治的ASO患者80例,采用随机对照研究方法,以随机数字表法分为对照组、观察组各40例,对照组予下肢动脉旁路移植术,观察组予血管内支架治疗。比较两组近期及随访1年的临床疗效、踝肱指数和跛行距离、足背动脉血流动力学指标、下肢神经传导速度、术后并发症。结果观察组总有效率为87.5%(35/40),明显高于对照组的67.5%(27/40)(Z=2.00,P<0.05);术后随访1年,观察组总有效率为70.0%(28/40),高于对照组的47.5%(19/40),但差异无统计学意义(Z=1.77,P>0.05)。治疗后,观察组踝肱指数和跛行距离均明显高于、长于对照组(t=3.34、8.30,均P<0.001),足背动脉内径、血流峰速及血流量均明显优于对照组(t=6.98、4.46、5.95,均P<0.001),下肢神经传导速度明显快于对照组(t=3.01、3.70,均P<0.001)。观察组术后并发症发生率为5.0%(2/40),低于对照组的15.0%(6/40),但差异无统计学意义(P>0.05)。结论相较于下肢动脉旁路移植术,应用血管内支架治疗ASO有较好的近期和远期疗效,可改善踝肱指数和跛行距离,改善足背动脉血流动力学指标,提高下肢神经传导速度,术后并发症较少。Objective To investigate the short-term and long-term efficacy of endovascular stent therapy for lower extremity atherosclerotic occlusive disease.Methods Eighty patients with lower extremity atherosclerotic occlusive disease who received treatment in Lishui Central People's Hospital from January 2020 to January 2021 were included in this study.They were randomly divided into control and observation groups,with 40 patients in each group.The control group received lower extremity artery bypass grafting,and the observation group received endovascular stent therapy.Clinical efficacy,ankle-brachial index,claudication distance,blood flow dynamics of dorsalis artery,nerve conduction velocity of the lower extremities,and postoperative complications were compared between the two groups in the short-term and 1-year follow-ups.Results Total response rate in the observation group was 87.5%(35/40),which was significantly higher than 67.5%(27/40)in the control group(Z=2.00,P<0.05).At 1-year follow-up,total response rate in the observation group was 70.0%(28/40),which was slightly,but not significantly,higher than 47.5%(19/40)in the control group(Z=1.77,P>0.05).After treatment,the ankle-brachial index and claudication distance in the observation group were significantly higher than those in the control group(t=3.34,8.30,both P<0.001).The diameter,peak velocity and blood flow of dorsal foot artery in the observation group were significantly superior to those in the control group(t=6.98,4.46,5.95,all P<0.001).Lower extremity nerve conduction velocity in the observation group was significantly higher than that in the control group(t=3.01,3.70,both P<0.05).The incidence of postoperative complications in the observation group was slightly,but not significantly,lower than that in the control group[5.0%(2/40)vs.15.0%(6/40),P>0.05].Conclusion Compared with lower extremity artery bypass grafting,endovascular stent therapy has good short-term and long-term efficacy in the treatment of lower extremity atherosclerotic occlusive disease.En

关 键 词：闭塞性动脉硬化 下肢 血管内支架 下肢动脉旁路移植术 治疗结果 踝肱指数 跛行距离 血流动力学 神经传导速度 

分 类 号：R654.4[医药卫生—外科学]