不同腔内治疗方式在短段股腘动脉硬化闭塞症中的效果  

Effect of Different Endovascular Treatment Methods in Short-Segment Femoral-Popliteal Arteriosclerosis Obliterans

作　　者：刘时标 吴世勇[1] 崔松岭 陈宁恒[1] 张闯[1] 郭学利[1] LIU Shibiao;WU Shiyong;CUI Songling;CHEN Ningheng;ZHANG Chuang;GUO Xueli(Department of Vascular Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院血管外科,河南郑州450000

出　　处：《河南医学研究》2023年第2期208-213,共6页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20200342)。

摘　　要：目的分析不同的腔内治疗方式在短段股腘动脉硬化闭塞症患者中的临床效果。方法收集2018年1月至2021年6月郑州大学第一附属医院血管外科收治的74例应用不同腔内治疗方式的短段股腘动脉硬化闭塞症患者的临床资料,其中血管腔内治疗方式包括药物涂层球囊(DCB)、金属裸支架植入术(BMS)、普通球囊扩张成形术(POBA)3种方式。根据腔内治疗方式将其分为DCB组、BMS组、POBA组,对比术前术后不同时间的Rutherford分级、踝肱指数、一期通畅率及再狭窄率、不良事件发生率、再干预率。结果3组术后踝肱指数及Rutherford分级均较术前改善(P<0.05);术后12个月,DCB组、BMS组的Rutherford分级、踝肱指数、一期通畅率均优于POBA组(P<0.05);术后12个月,DCB组、BMS组较POBA组一期通畅率高,DCB组较BMS组、POBA组再狭窄率低(P<0.05);3组不良事件发生率、术后12个月内再干预率比较,差异无统计学意义(P>0.05)。结论DCB与BMS治疗短段股腘动脉硬化闭塞症的近期效果相当且均优于POBA,DCB相较于BMS与POBA能够降低再狭窄率。Objective To analyze the clinical effect of different endovascular treatment methods in patients with short-segment femoral-popliteal arteriosclerosis obliterans.Methods The clinical data of 74 patients with short-segment femoral-popliteal arteriosclerosis obliterans who were treated with different endovascular treatment methods in the Department of Vascular Surgery of the First Affiliated Hospital of Zhengzhou University from January 2018 to June 2021 were collected.The endovascular treatment methods include drug-coated balloon(DCB),bare metal stent(BMS)and plain old balloon angioplasty(POBA).They were divided into DCB group,BMS group and POBA group according to endovascular treatment methods.The Rutherford grading,ankle-brachial index,primary patency rate,restenosis rate,adverse event rate and re-intervention rate at different times before and after surgery were compared.Results The postoperative ankle-brachial index and Rutherford grade in the three groups were improved compared with those before operation(P<0.05).At 12 months after operation,the Rutherford grade,ABI and primary patency rate in the DCB group and BMS group were better than those in the POBA group(P<0.05).At 12 months after operation,the primary patency rate rate in DCB group and BMS group was higher than that in POBA group,and the restenosis rate in DCB group was lower than that in BMS group and POBA group(P<0.05).There was no statistical difference in the incidence of adverse events and the re-intervention rate within 12 months after surgery among the three groups(P>0.05).Conclusion The short-term efficacy of DCB and BMS in the treatment of short-segment femoral-popliteal arteriosclerosis obliterans is comparable and superior to POBA,and DCB can reduce the restenosis rate compared with BMS and POBA.

关 键 词：股腘动脉 动脉硬化闭塞症 血管腔内治疗 疗效 

分 类 号：R654.3[医药卫生—外科学]