肱动脉入路和股动脉入路治疗肠系膜上动脉病变的比较研究  

Comparative study of transbrachial access and transfemoral access in the treatment of mesenteric arterial diseases

作　　者：郭文颖 朱龙图 夏士博 张昊 陆清声 吴彪 包俊敏 赵志青 袁良喜 张雷 Guo Wenying;Zhu Longtu;Xia Shibo;Zhang Hao;Lu Qingsheng;Wu Biao;Bao Junmin;Zhao Zhiqing;Yuan Liangxi;Zhang Lei(Department of Vascular Surgery,The First Affiliated Hospital of Naval Medical University,Shanghai 200433,China)

机构地区：[1]海军军医大学第一附属医院血管外科,上海200433

出　　处：《中国血管外科杂志（电子版）》2023年第2期113-117,共5页Chinese Journal of Vascular Surgery(Electronic Version)

基　　金：上海市卫健委卫生行业临床研究专项基金(202240388);上海市科技创新行动计划(20S11901900;21Y11909200);海军军医大学第一附属医院“234学科攀峰计划”(2020YXK050)。

摘　　要：目的比较经肱动脉入路和经股动脉入路治疗肠系膜上动脉病变的效果。方法回顾性分析2020年6月至2022年7月海军军医大学第一附属医院73例接受肠系膜上动脉支架植入术和肠系膜上动脉取栓术的肠系膜上动脉病变患者临床资料,其中肱动脉组16例,股动脉组57例。比较两组间“超选”肠系膜上动脉的时间、术后卧床时间和术后并发症等指标。结果当肠系膜上动脉与主动脉夹角<90°时,肱动脉组“超选”肠系膜上动脉的时间比股动脉组更短(P=0.004),且术后卧床时间短(P<0.001)。当肠系膜上动脉与主动脉夹角≥90°时,肱动脉组术后卧床时间更短(P=0.045),“超选”肠系膜上动脉的时间差异无统计学意义(P=0.682)。肱动脉组和股动脉组在术后并发症的发生率方面差异无统计学意义(P>0.05)。结论经肱动脉入路治疗肠系膜上动脉病变能缩短术后卧床时间,且当肠系膜上动脉与主动脉夹角<90°时,经肱动脉入路“超选”肠系膜上动脉所用时间更短。Objective To assess the effect of transbrachial access compared with transfemoral access for endovascular procedures of mesenteric arterial diseases.Methods The clinical data of 73 patients with mesenteric arterial diseases who received endovascular stent placement procedures and thrombolysis of superior mesenteric artery in the First Affiliated Hospital of Naval Medical University from June 2020 to July 2022 were analyzed retrospectively.Among them,16 were in the brachial artery group,while 57 were in the femoral artery group.Duration of superior mesenteric artery selection,postoperative rest time in bed and postoperative complications between the two groups were compared.Results When the angle between superior mesenteric artery and aorta was less than 90°,the brachial artery group took a shorter time to super-select superior mesenteric artery than the femoral artery group(P=0.004),and the postoperative bed rest time was shorter(P<0.001).When the angle between superior mesenteric artery and aorta was greater than or equal to 90°,and postoperative bed rest time was shorter(P=0.045)in brachial artery group,and there was no significant difference in the time used for superior mesenteric artery super-selection between the two groups(P=0.682).There was no significant difference in the incidence of postoperative complications between the brachial artery group and the femoral artery group(P>0.05).Conclusion Transbrachial access for the treatment of superior mesenteric artery lesions may shorten the time of postoperative bed rest,and shorten the time of intraoperative selection of superior mesenteric artery when the angle between superior mesenteric artery and aorta is less than 90°.

关 键 词：肠系膜上动脉 肱动脉 股动脉 入路 支架 腔内治疗 

分 类 号：R654.3[医药卫生—外科学]