准分子激光消蚀术在下肢动脉缺血性疾病中的临床应用  

Clinical application of excimer laser ablation in lower extremity arterial ischemic diseases

作　　者：李阳阳 姚思成 唐加热克[1] 杨建平[1] 朱兵[1] 管圣[1] 戈小虎[1] 慈红波[1] Li Yangyang;Yao Sicheng;Tang Jiareke;Yang Jianping;Zhu Bing;Guan Sheng;Ge Xiaohu;Ci Hongbo(Department of Vascular Surgery,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]新疆维吾尔自治区人民医院血管外科,乌鲁木齐830001

出　　处：《国际外科学杂志》2023年第7期468-473,共6页International Journal of Surgery

基　　金：国家自然科学基金(82060096)。

摘　　要：目的评价准分子激光消蚀术(ELA)治疗下肢动脉缺血性疾病的治疗效果。方法回顾性分析2020年12月—2021年4月新疆维吾尔自治区人民医院收治的44例接受ELA治疗的下肢动脉缺血性疾病患者的临床资料。44例患者中, 下肢动脉硬化闭塞症(ASO)29例, 其中股动脉支架闭塞3例;糖尿病足(DF)8例;血栓闭塞性脉管炎(TAO)7例。观察指标包括目标血管通畅率、截肢率、血管再干预率和死亡率。计量资料以均数±标准差(x±s)表示, 多组间比较采用单因素方差分析, 组内比较采用配对样本t检验;计数资料组间比较采用χ^(2)检验。结果 44例患者手术成功率为100%。ASO组大截肢率为10.3%, 其余两组大截肢率均为0。三组小截肢率分别为6.9%、25.0%、28.6%, 三组血管再干预率分别为10.3%、12.5%、0。ASO组1年死亡率为10.3%, 其他两组1年死亡率均为0。ASO组2年死亡率为31.0%, DF组为12.5%, TAO组为0。结论 ELA治疗下肢动脉缺血性疾病安全、有效, 但结果仍需要更大的样本量和更长时间的临床随访去证实。Objective To evaluate the therapeutic effect of excimer laser ablation(ELA)in the treatment of lower extremity arterial ischemic diseases.Methods The clinical data of 44 patients with lower extremity ischemic diseases treated with ELA in the People′s Hospital of Xinjiang Uygur Autonomous Region from December 2020 to April 2021 were analyzed retrospectively.Among the 44 patients,there were 29 patients in lower extremity arteriosclerosis obliterans(ASO),including 3 patients with femoral artery stent occlusion.8 patients of diabetes foot(DF)and 7 patients of thromboangiitis obliterans(TAO).Observation indicators include target vascular patency rate,amputation rate,vascular reintervention rate and mortality rate.The measurement data were expressed as mean±standard deviation(x±s),one-way analysis of variance was used for inter-group comparison,and paired sample t-test was used for intra-group comparison.The Chi-square test was used for comparison between count data.Results The success rate of operation was 100%in 44 patients.The rate of major amputation in ASO group was 10.3%,while the other two groups had a major amputation rate of 0.The minor amputation rates of the three groups were 6.9%,25.0%and 28.6%,respectively.The vascular reintervention rate was 10.3%in ASO group,12.5%in DF group and 0 in TAO group.The 1-year mortality rate in the ASO group was 10.3%,while the other two groups had a mortality rate of 0.The 2-year mortality rate of the three group were 31.0%,12.5%and 0,respectively.Conclusion For the treatment of lower extremity arterial ischemic diseases,ELA is safe and effective,but the curative effect need to further clarify by large sample and long-term clinical follow-up observation.

关 键 词：激光 斑块消融 动脉硬化 下肢 血管疾病 

分 类 号：R543.5[医药卫生—心血管疾病]