斑块旋切术联合药物涂层球囊治疗下肢动脉硬化闭塞症的效果分析  

Effect analysis of directional atherectomy combined with drug-coated balloon in the treatment of lower extremity arteriosclerosis obliterans

作　　者：李润生[1] 赵晖[1] 郑新[1] 邓芝徽[1] LI Runsheng;ZHAO Hui;ZHENG Xin;DENG Zhihui(Department of Vascular Surgery,Zhongshan Hospital Affiliated to Dalian University,Dalian,Liaoning,116001,China)

机构地区：[1]大连大学附属中山医院血管外科,辽宁大连116001

出　　处：《当代医学》2023年第16期141-144,共4页Contemporary Medicine

摘　　要：目的探究斑块旋切术(DA)联合药物涂层球囊(DCB)治疗下肢动脉硬化闭塞症(ASO)对患者再狭窄率和晚期管腔丢失(LLL)、最小管腔直径(MLD)的影响及安全性。方法选取2018年9月至2019年12月本院收治的94例ASO患者作为研究对象,根据手术方案不同分为对照组(n=52)和实验组(n=42)。对照组采用DCB扩张,实验组在对照组基础上采用DA,比较两组手术前后Rutherford分级、踝肱指数(ABI)及术后再狭窄率、LLL、MLD、并发症发生情况。结果两组Rutherford分级与ABI组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:术后6、12个月,两组Rutherford分级均低于术前,ABI均高于术前,且术后12个月的Rutherford分级低于术后6个月,但术后12个月的ABI均低于术后6个月(P<0.05)。组间比较:术前,两组Rutherford分级、ABI比较差异无统计学意义;术后6、12个月,实验组Rutherford分级均低于对照组,ABI均高于对照组,差异有统计学意义(P<0.05)。术后6个月,实验组再狭窄率低于对照组,LLL小于对照组,MLD大于对照组,差异有统计学意义(P<0.05);术后12个月,实验组再狭窄率与术后6个月比较差异无统计学意义,对照组再狭窄率高于术后6个月,两组LLL均大于术后6个月,MLD均小于术后6个月,但实验组再狭窄率低于对照组,LLL小于对照组,MLD大于对照组,差异有统计学意义(P<0.05)。结论DA联合DCB能有效改善ASO患者的临床症状,同时,可减少患者术后LLL的发生,扩张管腔直径,降低术后再狭窄率,且安全性高,值得临床推广应用。Objective To investigate the effect of directional atherectomy(DA)combined with drug-coated balloon(DCB)on restenosis rate,late lumen loss(LLL)and minimal lumen diameter(MLD)in patients with arterio sclerosis obliterans(ASO)and safety.Methods A total of 94 patients with ASO admitted to our hospital from September 2018 to December 2019 were selected as the research subjects,and they were divided into control group(n=52)and experimental group(n=42)according to different surgical schemes.The control group was treated with DCB dilatation,and the experimental group was treated with DA on the basis of the control group,the Rutherford classification,ankle brachial index(ABI),and postoperative restenosis rate,LLL,MLD,complications before and after operation were compared between the two groups.Results There were significant differences in Rutherford classification and ABI between the two groups of group,time points and interaction(P<0.05).Comparison within the group:at 6 and 12 months after operation,Rutherford classification of the two groups was lower than that before operation,and ABI was higher than that before operation,Rutherford classification at 12 months after operation was lower than that at 6 months after operation,but ABI at 12 months after operation was lower than that at 6 months after operation(P<0.05).Comparison between groups:before operation,there were no significant differences in Rutherford classification and ABI between the two groups;at 6 and 12 months after operation,the Rutherford classification in the experimental group was lower than that of the control group,and the ABI was higher than that of the control group,the differences were statistically significant(P<0.05).At 6 months after operation,the restenosis rate in the experimental group was lower than that of the control group,the LLL was smaller than that of the control group,and the MLD was larger than that of the control group(P<0.05);at 12 months after operation,there was no significant difference in restenosis rate between the experimenta

关 键 词：下肢动脉硬化闭塞症 药物涂层球囊 斑块旋切术 再狭窄率 晚期管腔丢失 

分 类 号：R654.4[医药卫生—外科学]