膝下动脉硬化闭塞症的腔内治疗进展  

Progress of endovascular treatment for below-the-knee arteriosclerosis occlusive disease

作　　者：杨森[1] YANG Sen(Department of Vascular Surgery,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院血管外科,天津300192

出　　处：《中国城乡企业卫生》2024年第7期20-24,共5页Chinese Journal of Urban and Rural Enterprise Hygiene

基　　金：天津市科技计划项目(18ZXDBSY00110)。

摘　　要：目前,下肢动脉硬化闭塞症发病率逐年增加。针对髂动脉、股腘动脉闭塞的临床研究取得了令人满意的进展。膝下动脉硬化闭塞症患者的病变特点主要是血管病变长、血管口径细、钙化严重、缺血症状严重、合并基础疾病重。因此,膝下动脉病变的治疗难度大,且再闭塞率、截肢率均较高。既往认为腔内介入治疗更适用于缺乏可用静脉旁路者、基础疾病严重开放手术风险较高者等情况。但随着腔内介入器材的快速发展,腔内治疗膝下动脉病变的手段越来越多,临床疗效也有明显改善。目前,多项研究证实膝下动脉硬化闭塞症的腔内治疗是安全、有效的方法。但是,针对膝下动脉硬化闭塞症,无论单纯球囊扩张血管成形术、支架、药物球囊等腔内技术在膝下病变治疗中均无法达到治疗股腘病变的疗效。因此,本文对膝下动脉硬化闭塞症的腔内治疗方法及进展进行介绍,以期为膝下动脉硬化闭塞症的治疗提供参考。At present,the incidence of lower extremity arteriosclerosis occlusive disease is increasing year by year.The clinical studies targeting the occlusion of the iliac and femoropopliteal arteries have made satisfactory progress.The lesions of patients with below-the-knee arteriosclerosis occlusive disease are mainly characterised by long vascular lesions,fine calibre vessels,severe calcification,severe ischaemic symptoms and severe comorbid underlying diseases.Therefore,the difficulty of treatment of below-the-knee arterial lesions is high,and the rates of reocclusion and amputation are high.Previous studies have suggested that endovascular interventional therapy is considered to be more suitable for those who lacked available venous bypass and those who had severe underlying diseases with high risk of open surgery.However,with the rapid development of endoluminal interventional devices,endovascular treatment methods of below-the-knee arterial lesions are more and more,and clinical effectiveness have improved significantly.Currently,several studies have confirmed that endovascular treatment of below-the-knee atherosclerosis occlusive disease is a safe and effective method.However,for below-the-knee atherosclerosis occlusive disease,endovascular techniques such as simple balloon dilatation angioplasty,stenting and pharmacological ballooningare not able to achieve the efficacy as femoropopliteal lesions in the treatment of below-the-knee lesions.Therefore,this article introduces the methods and progress of endovascular treatment of below-the-knee arteriosclerosis occlusive disease,in order to provide reference for the treatment of below-the-knee arteriosclerosis occlusive disease.

关 键 词：动脉硬化闭塞症 缺血 膝下动脉 腔内治疗 

分 类 号：R654.4[医药卫生—外科学]