经皮腔内血管成形术联合血管内支架植入术治疗老年下肢动脉硬化闭塞症的疗效  

Efficacy of percutaneous transluminal angioplasty and stenting in the treatment of elderly lower extremity arteriosclerosis obliterans

作　　者：林朝上 陈剑伟 黄艺生 杨利 Lin Chaoshang;Chen Jianwei;Huang Yisheng;Yang Li(Department of Radiology,the 900th Hospital of China People's Liberation Army Joint Logistics Support Force,Fuzhou 350025,Fujian,China;Department of General Surgery,the 900th Hospital of China People's Liberation Army Joint Logistics Support Force,Fuzhou 350025,Fujian,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇〇医院放射诊断科,福建福州350025 [2]中国人民解放军联勤保障部队第九〇〇医院普通外科,福建福州350025

出　　处：《血管与腔内血管外科杂志》2024年第4期429-433,共5页Journal of Vascular and Endovascular Surgery

基　　金：福建省引导性项目(2018Y0069)。

摘　　要：目的探讨经皮腔内血管成形术联合血管内支架植入术(PTAS)治疗老年下肢动脉硬化闭塞症(LEAO)的疗效。方法收集2019年1月至2022年10月中国人民解放军联勤保障部队第九〇〇医院收治的54例老年LEAO患者的临床资料,所有患者均采用PTAS进行介入治疗,分析患者的临床疗效、并发症发生情况、治疗前后足背动脉血流动力学指标(血流峰速、内径、血流量)、治疗前后下肢神经传导速度指标[运动神经传导速度(MNCV)、感觉神经传导速度(SNCV)]以及不同时间(治疗前、治疗后1个月、治疗后2个月、治疗后3个月)的踝肱指数(ABI)。结果老年LEAO患者的总有效率为94.44%(51/54)。与治疗前相比,治疗后老年LEAO患者足背动脉的血流峰速明显降低,内径、血流量、MNCV、SNCV均明显升高,差异均有统计学意义(P﹤0.01)。老年LEAO患者治疗后1个月、治疗后2个月、治疗后3个月的ABI均高于治疗前,差异均有统计学意义(P﹤0.05)。随着治疗时间的延长,老年LEAO患者的ABI逐渐升高,差异有统计学意义(P﹤0.05)。结论PTAS治疗老年LEAO的疗效显著,并发症较少,可改善足背动脉血流动力学指标和ABI,提高下肢神经传导速度,值得临床推广应用。Objective To investigate the efficacy of percutaneous transluminal angioplasty and stenting(PTAS)in the treatment of elderly lower extremity arteriosclerosis obliterans(LEAO).Method The clinical data of 54 elderly LEAO patients admitted to the 900th Hospital of China People's Liberation Army Joint Logistics Support Force from January 2019 to October 2022 were collected.All patients were treated with PTAS for intervention.The clinical efficacy,incidence of complications,hemodynamic indicators(peak blood flow velocity,inner diameter,blood flow)of the dorsalis pedis artery before and after treatment,lower extremity nerve conduction velocity indicators[motor nerve conduction velocity(MNCV),sensory nerve conduction velocity(SNCV)]before and after treatment,as well as ankle brachial index(ABI)at different times(before treatment,1 month after treatment,2 months after treatment,and 3 months after treatment)were analyzed.Result The total effective rate of elderly LEAO patients is 94.44%(51/54).The peak blood flow velocity of the dorsal foot artery in elderly LEAO patients after treatment was significantly lower than that before treatment,and the diameter,blood flow,MNCV,and SNCV were significantly higher than those before treatment,and the differences were statistically significant(P<0.01).After 1 month,2 months,and 3 months of treatment,the ABI of elderly LEAO patients was higher than before treatment,and the differences were statistically significant(P<0.05).With the prolongation of treatment time,the ABI of elderly LEAO patients gradually increased,and the difference was statistically significant(P<0.05).Conclusion The PTAS for the treatment of elderly LEAO has a significant therapeutic effect,with fewer complications.It can improve the hemodynamic indicators and ABI of the dorsal foot artery,increase the conduction velocity of lower extremity nerves,and is worthy of clinical promotion and application.

关 键 词：经皮腔内血管成形术 血管内支架置入术 老年 下肢动脉硬化闭塞症 疗效 

分 类 号：R543[医药卫生—心血管疾病]