药物涂层球囊联合准分子激光斑块消蚀术处理下肢动脉硬化闭塞症的临床研究  

Clinical Study on the Treatment of Lower Extremity Arteriosclerosis Obliterans by Drug-Coated Balloon Combined with Excimer Laser Atherectomy

作　　者：张超 冯建宇 王华[1] 樊朋程 张延军 曹敏 赵亮 ZHANG Chao;FENG Jianyu;WANG Hua;FAN Pengcheng;ZHANG Yanjun;CAO Min;ZHAO Liang(Department of Cardiac and Major Vascular Surgery,Xi′an Gaoxin Hospital,Shaanxi Xi′an 710077,China;Vascular Surgery Department,East District of the First Affiliated Hospital of Xi′an Jiaotong University,Shaanxi Xi′an 710089,China)

机构地区：[1]西安高新医院心脏大血管外科,陕西西安710077 [2]西安交通大学第一附属医院东院血管外科,陕西西安710089

出　　处：《中国医药导刊》2023年第10期1040-1044,共5页Chinese Journal of Medicinal Guide

摘　　要：目的:探讨药物涂层球囊(DCB)联合准分子激光斑块消蚀术(ELA)处理下肢动脉硬化闭塞症(LEASO)的临床疗效。方法:以2018年4月至2022年4月我院收治的84例LEASO患者为研究对象,按随机数字表法分为DCB组、DCB+ELA组,每组各42例。DCB组行DCB治疗,DCB+ELA组应用ELA联合DCB治疗,进行为期1年的随访,比较两组患者的临床指标、术中及术后并发症发生情况、预后。结果:与术前(T0时点)比较,术后6个月(T1时点)时两组患者踝肱指数(ABI)及靶血管最小管腔直径(MLD)均有提高,且DCB+ELA组患者T1时点ABI及MLD均高于DCB组,而T1时点DCB+ELA组患者靶血管晚期管腔丢失(LLL)低于DCB组(P<0.05)。两组患者术中及术后并发症发生情况比较,差异均无统计学意义(P>0.05)。术后随访1年,两组患者靶血管血运重建率、无截肢生存率及病死率比较,差异均无统计学意义(P>0.05),DCB+ELA组再狭窄率为7.14%,低于DCB组的26.19%(P<0.05)。结论:DCB联合ELA处理LEASO可获确切临床效果,术中及术后并发症发生率较低,且预后良好。Objective:To investigate the clinical efficacy of drug-coated balloon(DCB)combined with excimer laser atherectomy(ELA)in the treatment of lower extremity arteriosclerosis obliterans(LEASO).Methods:84 LEASO patients admitted to our hospital from April 2018 to April 2022 were selected and randomly divided into the DCB group(n=42 cases)and the DCB+ELA group(n=42 cases).1-year follow-up was conducted to compare the clinical indicators,incidence of intraoperative and postoperative complications,and prognosis of the two groups of patients.Results:Compared with preoperative T0 time point,the ankle-brachial index(ABI)and target vessel minimum luminal diameter(MLD)of patients in both groups increased at the sixth month after surgery(T1 time point).At T1 time point,the ABI and MLD of patients in the DCB+ELA group were higher than those of the DCB group and the late lumen loss(LLL)of target vessel of patients in the DCB+ELA group was lower than that of DCB group(P<0.05).There was no statistical difference in the incidence of intraoperative and postoperative complications between the two groups(P>0.05).After 1 year follow-up,there was no statistical difference in the rates of target vessel revascularization,survival without amputation and mortality between the two groups(P>0.05).The restenosis rate in the DCB+ELA group was 7.14%,which was lower than than that of the DCB group(26.19%)(P<0.05).Conclusion:DCB combined with ELA in the treatment of LEASO can achieve definite clinical effect,with low incidence of intraoperative and postoperative complications and good prognosis.

关 键 词：下肢动脉硬化闭塞症 药物涂层球囊 准分子激光斑块消蚀术 

分 类 号：R654.4[医药卫生—外科学]