药物涂层球囊联合血栓抽吸治疗亚急性下肢动脉栓塞的效果研究  

Effect of drug-coated balloon combined with thrombus aspiration in the treatment of subacute lower extremity arterial embolism

作　　者：卫飞鹏 王国壮 惠满靖 WEI Fei-peng;WANG Guo-zhuang;HUI Man-jing(Department of Interventional Pain,the Second Affiliated Hospital of Air Force Medical University of PLA,Xi'an 710038,Shaanxi,CHINA;Department of Intervention,Fuping County Hospital,Fuping 711700,Shaanxi,CHINA)

机构地区：[1]中国人民解放军空军军医大学第二附属医院介入疼痛科,陕西西安710038 [2]富平县医院介入科,陕西富平711700

出　　处：《海南医学》2024年第1期35-39,共5页Hainan Medical Journal

基　　金：陕西省重点研发计划项目(编号:S2020-YBSF-0042)。

摘　　要：目的探讨药物涂层球囊联合血栓抽吸治疗亚急性下肢动脉栓塞的效果。方法选择2018年1月至2022年1月中国人民解放军空军军医大学第二附属医院收治的78例亚急性下肢动脉栓塞患者进行前瞻性研究,根据随机数表法将患者分为对照组和研究组,每组39例。对照组患者接受血栓抽吸治疗,研究组患者在对照组治疗的基础上联合药物涂层球囊治疗。比较两组患者术前与术后即刻的静脉通畅评分、静脉通畅率;比较两组患者术前、术后即刻及术后6个月的股腘动脉最小管腔直径和踝肱指数(ABI);比较两组患者术前、术后24 h及术后2周的血管内皮功能[包括内皮素-1(ET-1)、一氧化氮(NO)]。结果治疗前,两组患者的静脉通畅评分比较差异无统计学意义(P>0.05),治疗后,两组患者的静脉通畅评分均明显降低,且研究组患者的即刻静脉通畅评分为(2.06±0.42)分,明显低于对照组的(2.37±0.60)分,静脉通畅率为(73.32±9.61)%,明显高于对照组的(62.41±10.85)%,差异均有统计学意义(P<0.05);治疗前,两组患者的股腘动脉最小管腔直径和ABI比较差异均无统计学意义(P>0.05),治疗后即刻与治疗6个月后,两组患者的股腘动脉最小管腔直径、ABI均明显升高,且研究组患者的股腘动脉最小管腔直径、ABI分别为(3.50±0.79)mm、0.88±0.14和(3.25±0.64)mm、0.87±0.15,明显高于对照组的(3.09±0.73)mm、0.79±0.12和(1.58±0.42)mm、0.63±0.10,差异均有统计学意义(P<0.05);治疗前,两组患者的ET-1、NO水平比较差异均无统计学意义(P>0.05),治疗后24 h与治疗2周后,两组患者的ET-1水平明显升高、NO水平明显降低,且研究组患者的ET-1水平分别为(67.23±7.08)pg/mL、(65.79±6.75)pg/mL,明显低于对照组的(71.23±7.52)pg/mL、(70.56±6.58)pg/mL,NO水平为(32.62±4.23)pg/mL、(33.76±4.41)pg/mL,明显高于对照组的(28.48±4.21)pg/mL、(30.21±4.72)pg/mL,差异均有统计学意义(P<0.05)。结论药物涂层�Objective To investigate the effect of drug-coated balloon combined with thrombus aspiration in the treatment of subacute lower extremity arterial embolism.Methods Seventy-eight patients with subacute lower ex-tremity arterial embolism admitted to the Second Affiliated Hospital of Air Force Medical University of PLA from Janu-ary 2018 to January 2022 were selected for the prospective study.They were divided into a control group and a study group according to random number table method,with 39 patients in each group.The patients in the control group re-ceived thrombus aspiration,and the patients in the study group received drug-coated balloon treatment on the basis of the control group.The venous patency score and venous patency rate before and immediately after operation were com-pared between the two groups.The minimum lumen diameter of femoral popliteal artery and ankle brachial index(ABI)were compared between the two groups before operation,immediately after operation,and 6 months after operation.The vascular endothelial function[including endothelin-1(ET-1)and nitric oxide(NO)]before operation,24 h and 2 weeks after operation were compared between the two groups.Results Before treatment,there was no significant difference in venous patency score between the two groups(P>0.05).Immediately after treatment,the venous patency scores of the two groups were significantly decreased,and the score in the study group was(2.06±0.42)points,which was significant-ly lower than(2.37±0.60)points in the control group,and the venous patency rate was(73.32±9.61)%,significantly high-er than(62.41±10.85)%in the control group(P<0.05).Before treatment,there was no significant difference in the mini-mum lumen diameter of femoral popliteal artery and ABI between the two groups(P>0.05).Immediately after treatment and 6 months after treatment,the minimum lumen diameter and ABI in the two groups were significantly increased,and the minimum lumen diameter and ABI in the study group were(3.50±0.79)mm,0.88±0.14 and(3.25±0.64)mm,0.87

关 键 词：下肢动脉栓塞 亚急性 药物涂层球囊 血栓抽吸 疗效 血管内皮功能 

分 类 号：R658.3[医药卫生—外科学]